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10. 1 am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 5°F (it food Is used the followln e, maintain below 41 OF temperature): <br /> ce chests Refrigerator <br /> —Refrigerated truck Ice bath and tubs <br /> Cher(specify).____-- ----—----- ---- - _ _--- --- <br /> 11. IL t providing the folloWng Items within my booth for the sanitary cleaning of food preparation utensil <br /> urhree compartment sink. <br /> Uri <br /> Threo deep tubs (basins 6-8 Inches minimum), one for soapy water, one for rinsing and one for a bleach <br /> Pion (one tablespoon of bleach per gallon of water). <br /> etergeni,bleach, and wiping cloths(cleaning towels). <br /> ub 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 /> nNater supply dispenser with warns water at a minlmum of 100°F=(i.e. 5-20 gallon container with spigot). <br /> N7ne separate tub(bucket or basin) for the collection of rinse/wastewater. <br /> aper towels and pump-style soap container. <br /> 13, Naynes of esponslble persons to bo present In booth during all hours of operation: <br /> �l <br /> *Important'* All Iood 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. Rellum original to festival coordinator three weeks priloy to <br /> thl event. <br /> 14. Completed by: r l het SUBMI!T` <br /> ature 'title Date <br /> s•zo ant. <br /> Health Permit } ria„u ,tsl,wmlor <br /> 9lerrw wrChaBing w <br /> n�eh <br /> P&pas iin,tA Tavrcl5 <br /> Snag d,sµnnse, — !! <br /> GNl'n q�f3as,d Santii[or huckei- r <br /> bleach Swamoor <br /> F�opanns:nun Bleach swr;ndxiplAqcmlhs l <br /> 8pnlh must he on <br /> I <br /> r� Concreta,AsphRll, <br /> U Plywood,or a Tarr. <br /> Prooane7adh - - <br /> sanpan�waler ninsawa;ar Oleachendwcter Garbage <br /> can <br /> Cr <br /> fire FxI�n�Vlshor 1 <br /> EaVa � <br /> 5'JrdRi <br /> i <br /> Ice Cooler ' F 5GMI15,1rvra6h <br /> QWO ko uags&rawconta4mrs mist bi ' wssiawaiar En1I&oar ' <br /> shred�Irxr,es o!9 01 the llralna'1 <br /> 1868 r7-. Hazellorr Avenue I Stockton,Califoiftia 95205 T 209 468-3420 j F 209 464-0130 1 www.sjgov.org/ehd <br /> Clip 18.M Page 8 of 11 TEMP EVENT APP <br /> OS13&'18 <br />