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f= f� SAN�IDA0UIN Environmental Health Department <br /> U �' --COUNTY— <br /> C'�na�+'�*• C,reorness grows here. <br /> 10. 1 am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 45aF(if food is used the following day,maintain below 41 aF temperature): <br /> Z tce chests ❑Refrigerator <br /> ❑Refrigerated truck 9Ice 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 /> ❑ 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 /> 12 1 am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br /> booth <br /> Q Water supply dispenser with warm water at a minimum of 100"F (i.e.5-20 gallon container with spigot). <br /> Q One separate tub(bucket or basin)for the collection of rinse/wastewater_ <br /> Paper lowets and pump-style soap container. <br /> 12 Names of responsible persons to be present m booth during all hours of operation <br /> A `_ T. ILJ <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 /> 14. Co,rlpleterj by <br /> Signatur 1 Title Date <br /> Heshtl Perrnit <br /> ='pore r4aAi r:rwela <br /> Sa•r h•,p,.,... <br /> ;ra:.B.r: Saralm bpca9- <br /> flk.r.h;i Wlpte.i. <br /> f�lct,.li slw-r]a<:^�51[k�nR <br /> BROtn must be or. <br /> U Conoete,Asphalt. <br /> 2; Plywl>pd or a Taru <br /> .`.cap.an•t wnira 4mse W.I.:( fllea[A aw Walm <br /> Garbage <br /> Ca'l <br /> r.ba <br /> W-rl.•i <br /> Icy CooEer <br /> 5 fat Iln,ul iaay <br /> f.r•,.P.Nay.6 Fuld eanfarmrs n,,,y Rr Wnalowalci <br /> .1",fl,'j—04 al The ymod` <br /> 1868 E Ffazelton Avenue I Stockton,California 95205 I T 209 468-3420 I F 209 464-0138 I www.s}gov.org/ehd <br /> EHD It,02 Pane 8 rrl 11 TEAIP EVENT na'e <br /> OG1,09JA123 <br />