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R EC-008 <br /> SAN I.J OAQ U IN Environmental Health Department <br /> i <br /> COUNTY <br /> `'Ire,,. tvl r'ilf lbr's; ijfil:VS flr'!r' <br /> 10. I 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 /> Q-Ieechests ❑ Refrigerator <br /> ❑ Refrigerated truck EIJ-1[65bath and tubs <br /> ❑ Other(specify) <br /> 11. 1 am roviding the following items within my booth for the sanitary cleaning of food preparation utensil <br /> Vhree compartment sink. <br /> OR <br /> ee 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 /> [D-15etergent, bleach, and wiping cloths(cleaning towels). <br /> C�-Tub to store wiping cloths in bleach solution. <br /> 12. f am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br /> booth: <br /> aWater 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 rinse/wastewater. <br /> ED-aper towels and pump-style soap container. <br /> 13. Names of responsible per$ ns to be present In booth during all hours of operation; <br /> s • <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. Comploted by: S' J�/ CJGl1Gtcs/ <br /> Signature Title Date <br /> s< "� 5•20 cal. k <br /> Health Permit Handwaslrwnler F <br /> .Slornow,Chslfing I <br /> orsr, <br /> Paper Hand Towels <br /> Soap dispenser 1l <br /> cutuna l3onsd Saoltlufbaekei- <br /> bloadi&waler rn1 <br /> Propano SSova Dead) storing Wping crops I <br /> Booth niusl be an <br /> Concrete,Asphall, <br /> a: "yam Plywood,or a Tarp. <br /> _.. , <br /> Propano Tank <br /> Soap m,d water Mali WOW Bleach ell Mler Garbage ! <br /> Can j <br /> Fire Exlingulsher <br /> Err4rn � <br /> Wolor I <br /> 0r 6GalHandwasi <br /> ExL,o ko Fags G Food Corllaiiers musl bo waslevraler conlalner <br /> Ice COUI <br /> $bred G faches 011 o1 rho oroundt <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 j T 209 468-3420 F 209 464-0138 ` www.sjgov.org/ehd I <br /> EHD 16.02 Pago B of 1 I TEMP EVENT MP <br /> 06119/19 <br />