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,gee <br />ria:enc.n <br />1 <br />Sasa.resroirs <br />*ober to. <br />0.4:44%) clE.111 <br />' T <br />pale t " <br />wevw spov org fahl <br />TEIAP EVENT APP <br />Boots mu. be VI <br />Concrete Asphalt <br />Piirh•Ood UT a Tare <br />Garbage <br />Can <br />,.. I 4A., <br />I <br />r ..+0.1 c.dow <br />r Health Permit <br />I ' ,Thn.l e....wo j ........-1 <br />1 <br />\ 1 1 <br />I <br />1 rrrl,,,i've41. r 4 4. <br />SANAOAQUIN Environmental Health Department <br />10. I am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br />1 <br />4 F' (if ' food is used the following day. maintain below 41'F temperature): /23,.. <br /> <br />-*COUNTY <br />Ice chests 0 Refrigerator <br />0 Refrigerated truck 0 Ice bath and tubs <br />0 Other (specify) <br />11. I am providing the following items within my booth for the sanitary cleaning of food preparation utensd <br />CI Three compartment sink <br />OR <br />Three deep tubs (basins 6-8 inches minimum), one for soapy water, ono for rinsing and one for a bleach <br />solution (one tablespoon of bleach per gallon of water) <br />ED Detergent, bleach, and wiping cloths (cleaning towels) o Tub to store wiping cloths in bleach solution <br />12. I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth <br />1)4Water supply dispenser with warm water at a minimum of 100'F (i e. 5-20 gallon container with spigot) <br />)2r6rie separate tub (bucket or basin) for the collection of anse'wastewater <br />, Paper towels and purnftstylq...soap container <br />13 <br />- <br />13 Names of responsible persons to be present in booth during all h )urs of operation <br />—Important — All food vendor booths are subject to inspection Please make a copy of th S application in <br />preparation for this event A copy of this checklist mast be in tne booth at all hours of <br />preparation and operation Return original to festival coordinator three weeks prior to <br />this event, <br />14. Completect by • <br />Title <br />7 <br />Date