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SAN J O A Q U f N Environmental Health Department <br /> 10. 1 am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 45°F(if food is used the following day,maintain below 41eF temperature): <br /> 'Ice chests LJ Refrigerator <br /> 0 Refrigerated truck ❑Ice bath and tubs <br /> ❑Other(specify) <br /> 11. 1 am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> f]Three compartment sink. <br /> OR <br /> Three deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br /> solution(one tablespoon of bleach per gallon of water). <br /> Q Detergent,bleach,and wiping cloths(cleaning towels). <br /> Tub to store wiping cloths in bleach solution. <br /> 12. 1 am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br /> booth: <br /> Water supply dispenser with warm water at a minimum of 100"F(i.e.6-20 gallon container with spigot). <br /> One separate tub(bucket or basin)for the collection of rinsetwastewater. <br /> Paper towels and UuMp-stvle a container. <br /> 13. Names of responsible persons to be present in booth during all hours of operation: <br /> "Important" All food vendor booths are subject to inspection. Please make a copy of this application in <br /> preparation for this event. A copy of this checklist must be in the booth at all hours of <br /> oreparation. and operation- Return original to festival coordlnator_t�11 weeks prior to <br /> this <br /> v <br /> 14. Completed by: <br /> Signature Title Date <br /> 51"tial. <br /> Health Permit —7 Manawa:hwAW <br /> 4_ Sromo wl*haran� I Paper Z T..,. <br /> --- SoaO dapruerW_. 1 j— <br /> senftw buckle <br /> bleach&waw for <br /> Props�e Sbore <br /> Bleach Mwt"0`*n0 cbM <br /> Booth Ibe on <br /> Concrete, <br /> Asphah. <br /> �7 PMwood,or a Tarp. <br /> Prop—Tank <br /> Soap an6 Wats► Rune weer Bleaet acca waw Garbage <br /> �.J Can <br /> FV*E)MVWslur nwE*,-- <br /> Ice Cooler bww <br /> Extra ke&Vs d Food CMeftra nwsl be VWWW rater�0n�1 bf <br /> stotad 6 W"s o6 d tm 0MIM& <br /> 1868 E. Hazelton Avenue l Stockton, California 952051 T 209 468-3420 1 F 249 464-0138 ( www,sjcehd.com <br /> EHD 16-02 Page sof 11 TEMP EvENT APP <br /> 0713117 <br />