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R EC 008 <br /> ..�1.r,,r;rq .• i <br /> f ,. 5AN ;J0AQUIN Environmental Health Department <br /> COUNI <br /> .<;; �� (�repinr,ss rJrrl,•�s hr'1•c. I <br /> • v <br /> 0, 1 am providing the following cold temperature control for the cold holding of potenllally hazardous foods below <br /> 6IG <br /> al~(if food is used the followlnnice <br /> , maintain below 41 eF lemperature):echests Retrtgorator f <br /> efrlger>aled truck bath and tubs <br /> then(specify) ._ <br /> 11, ms providing tho following Ite within my booth for the sanitary cleaning of food preparation utensil <br /> DR 1 <br /> three compartment sink, <br /> ❑✓ Three deep tubs (basins 6-8 Inches minlrnum), one for soapy water, one for rinsing and one for a bleach <br /> tlon (one tablespoon of bleach por gallon of water), <br /> ✓ eiergenl,bleach, and wiping cloths(cleaning towels). <br /> f ub to More wiping cloths In bleach solution. I <br /> 12. 1 am providing the following for adequaiv hand washing facliities, but separate born utensil wash within my <br /> booth: <br /> ✓ Naier supply dispenser with warm water at a minimum of 1001E(Le. 5-20 gallon container with spigot). <br /> �7ne separate tub(buoket or basin) for the collection of rinselwastowater. <br /> aper towels and Pump•styie soap container. <br /> 13. Names of responsiblo persons to bo 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 /> preparallon for this event. A copy of this checklist must be In the booth at all hours of <br /> preparation and operation. Return odginal to festival caordlnator three weeks prior iR <br /> JIM even-A. <br /> 14. Completed by: Rawad Annan Manaa'et 0411.7I2Q24_ i °'SIJ.BCtili1T <br /> 9 griiure Title date <br /> xaaa 6.20 Gill <br /> Healih Permit iiandwashlValor <br /> ttlorm v�S;lm)fm; j <br /> 131sh <br /> Ynpar lio,lf 7o+rats l <br /> soap dlapansar <br /> CuICn(;13aard sanhhar hilckw- <br /> blaa[l,dwnlnr[or � <br /> Propane Have ulaac;, eUlns%VVnf C101hs <br /> Booth must be on <br /> -- ouncrele,Asphalt, j <br /> Plywood,qr a Tarp, t. <br /> _ rn °i•}`i'•."i: tt1.?I'�i•:'F4:: lib :aY}l1�'af:l�;'�`i;� l <br /> f'fapnnoTnnk <br /> ------------ <br /> I <br /> I <br /> K turn,a0 Wolof 111olo alm feachent Wnler <br /> C1Prhag4 ' <br /> can } <br /> 4 �ik � >=iraFxtinnuEahet l <br /> k]uo t <br /> stg:a' - I i <br /> ice Cooler iconlHantwssh l <br /> 1+ ralrn ka flaps S FondCanrnhers urusl ha WeciMM01 CMlnlner I <br /> 1866 C, Ilazellon Avenue j Stockton, California 95205 T 209 466-3420 1 ra 209 464-01 M j www,sjcgov,orglehd <br /> C1•1p ia•Pr Pegeant I1 TEMP r-VFNTAPP <br /> M119l19 <br />