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R EC-003 <br /> r;TT S A N A O A Q U I N Environmental Health Department <br /> —COUNTY— <br /> 10. 1 am providing the following cod temperature control for the cold holding of potentially hazardous foods below <br /> `F(if food is used the fcflowin maintain below 41°F temperature): <br /> cc chests eingerator <br /> etrigeratcd truck Rcc bath and tubs <br /> her(sp^cly) _ <br /> 11. prodding the foiloAing iterns within my booth for the sanitary clean;ng of food preparation utensi! <br /> Lj hree compartment sink. <br /> OR�nhree <br /> deep labs (basins 6.8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br /> (one tablespoon of bleach per g1on of water). <br /> ergent,bleach, and wiping cloths(cleaning towels). <br /> Tbu <br /> to store wiping cloths in bleach soluton.n . <br /> 12. 1 am prov'ding the following for adequate hand washing facilities, but separate from utensil wash within my <br /> booth: <br /> Dater supply dispenser wish warm water at a min mum of 100^F(i.e. 5.20 ga'lon container with spigot). <br /> T35nc separate tub(bucket or basin) for the collect;cn of rinse.-%vaste<valer. <br /> aper towns and puma-style_sogp container. <br /> 13. Names of responsible persons to be present in booth during all hours of operation: <br /> "Important" A4 lood veneor 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 o' <br /> preparation and operation. Return orf ly nal to festival coordinator three weeks_irior to <br /> 14. Completed by: ` ; v�.�;, � _%�•!� _ /� tIU r"�— ) i 17 1? SUBMIT <br /> slihaturei Tltle Date <br /> Health Per <br /> Ic <br /> .•�x,.y v ln<c. <br /> .raj r:C:�^��• <br /> ❑C1 <br /> BCVAl•mcs:tr]oil <br /> Gx•cr--:e.AzDbalL <br /> PIjMVCi^,o:a Tara <br /> —_' ,y Sr-A 0'AA lr�w'h's•e- tiresa:�ri�:r [39IDx7 <br /> Can <br /> 'f:ilM..iv <br /> i <br /> Ice Cooler <br /> u.c r+•'rsS��:7 C.�•1^_z rt7.<.t.^ As.L r.e er C� srcr <br /> LJ'l t••t'Yt:�!N I!S�' <br /> 1868 E. hazclton Aven,;e Stockton,Ca:ilornia 95205, T 209 468-34<20 F 209 464-0136 1 wtitiA1W.sjgov.org:chd <br /> EHD•5 oT P>tge 6 of t 1 <br /> MAP CI.=N7 APP <br /> Scanned with CamScanner <br />