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AN JOAQUINEnvironmental e ltki Departnnent <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 41'F temperature): <br /> Ice chests ❑ Refrigerator <br /> El 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 /> ❑ Three compartment sink. <br /> OR <br /> L�1�, <br /> Three deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br /> s lution (one tablespoon of bleach per gallon of water). <br /> 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 /> T�Water supply dispenser with warm water at a minimum of 100'F (i.e. 5-20 gallon container with spigot). <br /> M One separate tub (bucket or basin)for the collection of rinse/wastewater. <br /> Paper towels and pump-style soap container. <br /> 13. Nam s of respo sible ersons t be resenl.in bo during all rs of oper tion: <br /> bb�i ��� tia ns�►ny <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 /> preparation aid o eration. Return original to festival coordinator three weeks prior to <br /> this event. <br /> 14. Completed by: <br /> Signature Title at <br /> 5-20 Gal <br /> Health Permit n rno w/ChaHand wash Water <br /> Steffing <br /> Dish <br /> Paper Hand Towels <br /> Soap dispenser <br /> Cutting Board <br /> Sanihzer bucket- <br /> bleach 8 water for <br /> Propane Stove Bleach <br /> storing wiping cloths <br /> Booth must be on <br /> Concrete,Asphalt, <br /> ❑' Plywood, or a Tarp. <br /> Propane 9�nl, Soap and Watr Rinse Water Bleach and Water Garbage <br /> Can <br /> Fire Extinguisher <br /> Extra <br /> t Ice Cooler --�- <br /> t7 77,13771 <br /> F 5 Gal Hand wash <br /> E Extra lce Bags 6 Food Containers must be Wastewater Container <br /> - -' ------- stored 6 inches oN o/the ground! <br /> '868 E e-1 , s~,.e,,ie . ( -3fOr^,ic 9F2^G, 2 <br /> 9 468-3420 I F 2rj;u 464-!D38 s;CehU' .,01"� <br /> EHD 16-02 Page 8 or 11 TEMP EVENT APP <br /> 07/3/17 <br />