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REC-008 <br /> SAN, I OAQUIN Env"ronmental Health Department <br /> 10. 1 am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 5°F(if food is used the followin 'j— aintain below 4loFlemperalure): <br /> Ice chests Lj,�Refrigerator <br /> efrigeraled truck FIce bath and tubs <br /> ther(specify) <br /> 11. providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> hree compartment sink. <br /> OR Dhree deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br /> ietergent,ion (one tablespoon of bleach per gallon of water). <br /> bleach, and wiping cloths(cleaning towels). <br /> (dub <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 /> [:]Nater supply dispenser with warm water at a minimum of I OOOF(i.e. 5-20 gallon container with Spigot). <br /> [:]Dne separate tub(bucket or basin) for the collection of rinse/wastewater. <br /> Raper towels and pump-style soap container. <br /> 13. Names of responsible persons to be present in booth during all hours of operation: <br /> C7�,D <br /> YA-eACA e1U"OVY"lCAV-\- CA.nMICA- <br /> P A.-AY A(D <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 opepation. Retum original to festival coordinator three weeks prior to <br /> this even <br /> 14. Completed by: �Wm__ - SUBMIT <br /> Signature Thle Dale <br /> 5-20 Gal. <br /> Heath Permit Sterno m Cha1fing HandwaShWater <br /> Dish I Pper Hand Towels <br /> Soap dispenser culling B r b.,,,c'e <br /> hleech <br /> Reach storing*ping i <br /> Booth must be on <br /> Concrete,Asphalt, <br /> ..... ... Plywood,or a Tarp. <br /> 9eapsndWinter Rinse taster Bleach <br /> car, <br /> ... ...... &tinqulsner <br /> Eva <br /> Ice Cooler 5 Gal Hari wash <br /> Exkra L-a Bsgs Food Conlaners iwsf be 't, ter Container <br /> =1,ws,be Was eye <br /> ,jg,=scored 6 inches off of the ground! <br /> 1868 E.Hazellon Avenue I Stockton,California 95205 1 T 209 468-3420 1 IF 209 464-0138 1 www.sjgov.ofg/ehd <br /> EHD 16-02 Page aof 11 TEMP EVENT AP P <br /> 06/19119 <br />