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t • <br /> REC-009 <br /> S A N J 0 AQU I N Environl� o�ntal Health Department <br /> -•—C®U NTY <br /> .,, ' C�r =rrlreL•, 11u,v1 lser . <br /> 10, 1 am providing the iollowing cold temperature control for the cold holding of potentially hazardous foods below <br /> 5OF(If food Is used the followfn aintaln below 41 OF temperature),. <br /> Ice chests Refrigerator <br /> efrigerated truck Ice bath and tubs <br /> iher(specify) <br /> 11, providing the following Items within my booth lorthe sanitary cleaning of food proparatlon utensil <br /> LLJ <br /> hr a compartment sink. <br /> OR <br /> hree deep tubs (basins ti•B inches minimum), one for soapy water, one for rinsing and one for a bleach <br /> tlon one tablespoon of bleach per gallon of water), <br /> etergent,bleach, and wiping cloths(cleaning towels). <br /> �1ub to store wiping cloths In bleach solution. <br /> 12, 1 am providing the following for adequate hand washing facllitles, bLrt separate from utensil wash within my <br /> booth: . <br /> ater supply dispenser with warm waterat a minlmum of 10011F(i.e. 5-20 gallon contalnerwiih spigot). <br /> IlDne separate tub(bucket or basin) for the collection of rinsetwastewater. <br /> Daper towels and pump-stylo soap container. <br /> 13. Names of r or sibi�,persopAo be present in booth during all hours of operation: <br /> •�( yaS J <br /> I <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 /> preparatio and operation. Return original to festival coordinator three weeks prior to <br /> 14. Completed by: �1 � l��f �y i SUBMIT <br /> Signature tilre ate <br /> 6 2a Gel. <br /> Health Permit Hand warh Walnr <br /> siarno w�hal line <br /> DO <br /> Yapar Hand TPWaii <br /> Snap dlepansor . <br /> Cu[lirgl 8aard BaaRiiar buckol- <br /> bleach dwalerlar <br /> Propane staaa Teach uorirs wring clalhs <br /> Booth r l be on <br /> Concrete,Asphalt, <br /> Plywood,0r a Tarp, <br /> � .L•'t'ti� Icy. <br /> PrapaaoTank - --... . <br /> soap arty Water Hlnco Writer bleach a6M water Cisrl]©gt3 <br /> Can <br /> Flra£allnl{illahar <br /> ExVa <br /> Water <br /> 71 <br /> Ice Cooler I - - 5Oa1Hanlwach ' <br /> una xn nags s rota�onrahaa narat oo wa"^"41er cO"'i"Of � <br /> alWad6rnaAasallar the pr W1 <br /> 1868 E, Hazelton Avenue I Stocklon,CaPfomla 95205 I T 209 4613-3420 i F 209 464-0138 1 www.sjgov.org/elid <br /> END 16.02 Page a of 11 TDAP EVENT APP <br /> 06719/t9 <br />