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REC-008 <br /> S A N 1111111 1J O A Q U I N Environmental Health Department <br /> 10. I am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 5°F(it loud is used the followin , maintain below 41'IF temperature): <br /> Ice chests Reingerator <br /> ✓ eingeraled truck oe bath and tubs <br /> lher(spepty) <br /> 1 t. Oproviding <br /> the following items within my booth for the sanitary cleaning of food preparation utensil <br /> hree compartment sink. <br /> OR <br /> []Three deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br /> Lion (one tablespoon o1 bleach per gallon of water). <br /> L_Pelergent,bleach, and wiping cloths(cleaning lowels). <br /> (dub to store wiping cloths in bleach solution. I <br /> UU <br /> 12. 1 am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br /> booth: <br /> ✓water supply dispenser with warm water at a minimum of 1001F(i.e. 5-20 gallon container with spigot). <br /> Dine separate tub(bucket or basin) for the collection of rinse!wastewaler. <br /> R�aper towels and puntD-style song container. <br /> 11 blames of responsible persons to be present in booth during all hours of operation: <br /> Usa Duncan <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 o ation. Ref rn original to feslival coordinator three weeks prior to ; <br /> this event. C <br /> 14. Completed by: Owner &W4 SUBMIT <br /> Signature Title pale <br /> I�r_Z'1h Pcrmil <br /> CwR •IrYh <br /> Sow 6wsma• -- ' <br /> G.,IbrV B.:JVtl Sid [['b,t[I <br /> 24"{f11lrIC- <br /> P7Aaxsa.• w•. _ v,v-•y rpry ri.,, M <br /> B000 mr.sl be on <br /> O Corcrele.Aspt•911, F <br /> F'lywoua,or p Tom i <br /> i"opav T a'=• <br /> 5aa3we vV*r P War 3faeh 1,4 e <br /> JAlY Gxmxge <br /> Cal- Iq <br /> F rtR EJ,IMJ,+hE, <br /> E•ts _ <br /> W,1o, <br /> Ice Cooler s�.lyna w <br /> era t+Btlgraam',r'rrramn rnn,M wa.+.r.r r..ri;r. <br /> itYad tl U['/IIN M M Its'yrirM' <br /> 1868 E. Hazellon Avenue I Slorklon,C,il,lnrnia W05 T 2Qq 468-3470 1 F 164 0131 y-�v.orp rhd <br /> Clfl 1 E 02 PW a al i s Tn.0 r Vrk'APP <br /> 06 T3 19 <br />