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r /+ <br /> RECO08 <br /> S A N o10 A Q U I N Environmental Health Department <br /> COUNTY— <br /> . <br /> Cirecitness glows here. <br /> 10, 1 am providing the following cold temperature control for the cold holding of potentially hazardous foods below" <br /> °F(if loud Is used the followln malniafn below 41'F temperature): <br /> Ice chests Refrigerator <br /> Refrigerated truck ce bath and tubs <br /> her(specify) <br /> 1 t. providing the following items within my boolh for the sanitary cleaning of food preparation utensil ' <br /> OR hree compartment sink. <br /> ., <br /> Three deep tubs (basins 6-8 inches minimum), one for soapy water, one far rinsing and one for a bleach <br /> Rn (one tablespoon o1 bleach per gallon of water). <br /> lergent,bleach, and wiping cloths(cleaning towels). <br /> uib 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 /> E]Naler supply dispenser with warm water at a minimum of 100`F(i.e. 5-20 gallon container with spigot). <br /> �ne separate tub(bucket or basin) for the collection of rinse/wastewater. <br /> E�aper towels andpump-slyle soap container. <br /> 13. Names of responsible persons to be present in booth during all hours of operation: <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. Re on Ina] to festival coordinator three weeks odor to <br /> eV t. <br /> 14. CompletedZCJBMIT <br /> to Title ate aa_i: _ <br /> 5-�a CLI- <br /> Health Permit Hand wash Water <br /> 5lerrn wrChalfine <br /> Gish <br /> Paper Na+>r TareEs <br /> Soap dispenser <br /> CUIGnp Boani Sanll"r twrkel- <br /> 4leach Bwalerlcr <br /> -Pmpaneslovc Bleach slnring Wa.0.Bans <br /> Booth must be on <br /> Comrete,Asphalt, <br /> Plywood,or a Tarp. <br /> Soap A"Water Rinse Walnr Blew anti Walnr <br /> Garbage <br /> Can <br /> Fire Edirrylaistter <br /> Extra <br /> Wator <br /> Ice Cooler f,". 5 Cial Road wash <br /> Fxlra AM Bags d FnW ronleiners rwsl be Waalexaler Container <br /> s otaci 6 kxfts d11 of the groundl <br /> 1866 E. Hazelton Avenue I Stockton,California 95205 1 T 209 468-3420 F 209 464-0138 1 www.sjgov.org/ehd <br /> EHQ 16-02 Page 8 0l 11 TEMP EVENT APP <br /> O&19119 <br />