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J seen—o-.1' <br />Was:eve-4er Canta,nts rice Cooler <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 operation. Return original to festival coordinator three weeks prior to <br />this event <br />Completed by: wawa icuf4.- zi z 7/ 23 <br />Signature Title •Date <br />Stemo.C.Erg <br />Disn <br />5-20 GA, <br />Hand wash Water <br />Cal 4,8 <br />Me MN I 1 Ni <br />Paper KW Temels <br />Sanitize bucket. <br />Snell & watts for <br />,rorn0opctOdcoho <br />Health Permit <br />Propane Sts,,e <br />Garbage <br />Can <br />Fte COO woflo <br />E4ra <br />Won <br />- <br />E40 Its Gags d Feed Contaiws mat be <br />Mead 6 Inches of alas prounal <br />Booth must be On <br />Concrete. Asphalt. <br />Plywood. or a Tarp. <br /> <br />4/27/23, 8:20 PM 45029759-C4133-48D3-13187-399AC6821690Ajpeg <br />SAN JOAQUIN <br /> <br />Environmental Health Department <br />—C OU N T <br /> <br />10. I am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br />45T (if food is used the following day, maintain below 41E temperature): <br />Ice chests 1fiigerat0r <br />Refrigerated truck 0 Ice bath and tubs <br />Other (specify) <br /> <br />11. I a roviding the following items within my booth for the sanitary cleaning of food preparation utensil <br />çyrtfree compartment sink. <br />OR 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 />ID Tub to store wiping cloths in bleach solution. <br />I urn 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. 5-20 gallon container with spigot). <br />Erone separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Epla per towels and pump-style soap container. <br />Names of responsible persons to be present in booth during all hours of operation: <br />( i-kuve,N) <br />ialE; E. ilaw.lton AvPrtuf Stc•rk'nn, Salifomig 9:2n5 I T 209 ‘168-3420 F 209 464-0138 www.sigov.orgfehd <br />Ftits tS-0, r%I f t . TEMP EVENT APP <br />19