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l�^GDC)�3 <br /> ;,;'i fI111JF;i; SANdOAQUIN Environmental Health Department <br /> —C®U N T Y— <br /> "'kfres0 G(U(Itrtr,ss grows flew. ? <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 followln , maintain below 41 nF temperature): <br /> ✓ Ica chests Refrigerator <br /> > ldgerated truck HIce bath and cubs <br /> Other(specify) <br /> i 1. t providing the following Items wl Ihln my booth for the sartllary cleaning of food preparation utensil <br /> 4� 'hree oomparlment sink. <br /> UR <br /> ✓ 'rhree deep tubs (basins 1;-13 Inches minimum), one for soapy water, one for rinsing and one for a bleach <br /> Ilon (one tablespoon of bleach per gallon of water), <br /> elergent,bleach, and wiping cloths(cleaning towels). i <br /> ub to store wiping cioihs In bleach solution, j <br /> 12. 1 am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br /> booth: <br /> ✓later supply dispenser with warm water at a minimum of 100°F(Le. 5-20 gallon container with spigot). <br /> F&_/�)no separate tub(bucket or basin) for the collection of rinsetwastewater. <br /> Vapor towels and pump-style soap oontainer. <br /> 13. Names of responsible persons to be present In boolh during all hours of operation: <br /> JASPREET KAUR PADAM <br /> a`Irnportant" All food vendor booths are subJeol 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, Belum original to festival oaardinaior three weeks prlor to <br /> Itils event. <br /> 14, Completed by: OWNER 04/2212024 <br /> Signature Tttle Date <br /> I1e�11111 Perlrlll 1+pnfswa:rlwntaf � <br /> Slonb Wr[:haffiA� <br /> dish <br /> 3'oper Flan!7awala <br /> Song ctlspansor <br /> Cu11+'nq E]aarU SanNlterhuckal- <br /> Tsfoadt d water for <br /> Pra�ena3lovn <br /> E1loael, t4arind tt1�In0 cb1119 <br /> Booth rnusf be oil <br /> Concrete,Asphurt. <br /> Plywood,or a Tarp, <br /> ti <br /> 1 <br /> gaaprtnlY{ales ftlnsaWbla E{pnchnnslWerar ourbsoe <br /> - rlr6 EalksX�Iatfaf <br /> loe Cooler5aolHanlwnsls <br /> / Ufa km fJagsd rrarlGal�fnhars nxrsl ha WAMWalar C(A%dwr <br /> 186B E. I-lazellan Avonue I Stookton,California 95205 7 209 468-3420 P 209 464.0138 1 www,slgDv.org/ehd <br /> f HD 111-02 Pogo,o of 11 7 NAP EVCNT AP P <br /> t)R11 k1119 E <br />