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SAN 1DAQUIN Environnimital Health Dvpartment <br /> 10 1 am provdrnq the following cold temperature control for the cold holding of potentially hazardous kxxls trk-%w <br /> 45 F Of food is usec the following Day. maintain below 4 t'F temperature). <br /> 4eIce chests ' Refregerator <br /> Refrgerated truck toe bath and tubs <br /> '—' Other(speafY) <br /> 1 i 1 I ate+providing the following rtems within my booth for the sanitary cleaning of food preparation utensil <br /> E-Three compartment sink. <br /> OR <br /> Three deep twos (basins 6-8 inches minimum). one for soapy water, one for rinsing and one for a bleach <br /> sd+ut,on lone 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 €aaiities, but separate from utensil wash within my <br /> booth: <br /> Water supply dispenser with warm water at a minimum of 100'F(i.e. 5-20 gallon container with spigot). <br /> One separate tub(bucket or basin)for the collecbon of rinsetwastewater. <br /> Paper towels and puV.styie soap container. <br /> 13. N!"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 /> preparation and Peration. Retum final t festival coordinator three weeks for to <br /> this event <br /> '14_ Completed by: L��YL4 3 zjr <br /> Signature Title Date <br /> � sr <br /> Health Perrllt <br /> ca4w I;,uW Ta..dla <br /> cM.irl S M.I:.•.' <br /> �'r•,y+M.V+l'Ih ?lR�, f�•r"�V:•{,"Ry'.-iillll� <br /> Booth must be on <br /> O Concrete,Asphalt. <br /> Plywood,or a Tarp, <br /> r••lw.s.ly <br /> Garbage <br /> Can <br /> Ern <br /> Waw <br /> Ice Cooler <br /> F.e..I!r Lwr/4 6 r.rrf C•..ruxnn nwtb� Wp;eM7lef Gonunar <br /> - .r..•w!r h.rrlr.r/r N eh.,grwM• <br /> 1s r•s F Hazolir n Ao-nue Storklon California 95205 1 T 209 468-3420 E F 209 464-0138 1 www.sjcehd.com <br /> r i+0 r'rre <br /> n ire i t Page a of 11 TEMP EVENT APP <br />