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—-O • <br />Environmental Health DepartmentSAN JOAQUIN <br />10 <br />11 <br />OR <br />12 <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 collection of nnseAvastewater <br />Paper towels and pump-style soap container <br />13 <br />••Important** <br />owner <br />Completed by14. <br />DateTitle <br />P>p»< 'Oftvi <br />3Prppr* Sacv* <br />Procerw <br />B>UC* •nd WJler <br />f 4r«>uith«r <br />Ice Cooler <br />Pagefioni <br />L«!n <br />Names of responsible persons to be present in booth dunng all hours of operation <br />Gary Blanco <br /> Ice chests <br />O Refrigerated truck <br />i ] Other (specify) <br />I am providing the following for adequate hand washing facilities but separate from utensil wash within my <br />booth <br />O'th <br />5 C* Hand <br />AMtvwftr Cnntorw <br />5-20 <br />k*vj wnn <br />txoc* <br />Mac*- 4 «a»r *or <br />tlonng wiprg OcXBi <br />t:______— <br />Health Permit <br />Jo <br />R>im WMk <br />n^L7 <br />Soto IM*tv <br />I am providing the following cold temperature control lor the cold holding of potentially hazardous fx>ds tx <br />45'F (if food is used the following day. maintain below 41 F temperature) <br />□Refrigerator <br /> Ice bath and tubs <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />XC Three compartment sink <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 /> Detergent, bleach, and wiping cloths (cleaning towels) <br /> Tub to store wiping cloths in bleach solution <br />Garbage <br />Can <br />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 operation Return original to festival coordinator three weeks prior totl^isjW^^l* 4/22/2022 <br />‘^Signature <br />1868 E Hazelton Avenue ! Siockton, California 95205 | T 209 468-3420 | F 209 464-0138 ] www.sjgov o^ ebd <br />EHDISeZ " Page 8 0111 ‘ TEMP EVENT APP <br />id <br />Booth must be on <br />Concrete Aspna’t <br />Plywood, or a Tarp <br />\_________________7