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7 R CC-00 6 <br /> SA N J OA Q U I N Environmental Health Department <br /> �`i`ll rr ttt+5 OrrSlr rl l'S$ ,rl I,5Y5 111'I i', <br /> 10. 1 am pmAding the following cold temperaluro control for the cold holding of potenllaily hazardous loods below <br /> 5°F(if food Is used the(ollowln rnnlnlnln balow 41 T tomporature): <br /> Ice chests Relrigornlor <br /> elrfgerpted truck co bath and tubs <br /> lher(speclly)_ — <br /> 11. �prmiding the following Items within my booth for the eanllary cleaning of food preparation utensil <br /> OR <br /> hree compartment slnk. <br /> AQT"hree deep tubs (basins 6-8 Inchon minimum), one for soapy water, one for rinsing and one for a bleach <br /> to n tone tablespoon of bleach per gallon of water). <br /> tergenl,bleach, and wiping cloths(cleaning towels). <br /> vb to store wiping cloths In bleach solution. <br /> 12, f am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br /> booth: <br /> OVater supply dispenser wllh warm water at a minimum of 100°F(Le. 5-20 gallon container with spigot). <br /> ne separate tub(bucket or basin) for the collection of rinse/wastewater. <br /> �Epaper towels and pump-style soap container. <br /> 13. Names of responsible persons to be present In booth during all hours of operation: <br /> ram► t Y, 4 14 t� --C6yyr_s <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 ail hours of <br /> preparation and operation. Rej orl Inal to lestivel coordinator three weeks prior to <br /> even . t/�_ oW ru�Y Z 2 <br /> 14. Completed b : — <br /> I lu Tillie ate <br /> 'i za ant. <br /> Heahh Permit rlandwnhwater <br /> Saerrn wR:harin� <br /> �'� Pnper Finl�'lowelS <br /> Sane dr5pp n&or <br /> Cplvnp board Sfl SriStAs q�ekel- <br /> hSear3i lZwele rior <br /> BlaflGh L;_14 <br /> WoM ',I <br /> Prapa ne BWVn <br /> Booth roust betx� <br /> � fvor�crete,Asphalt, <br /> Plywood,or a Tar¢ <br /> Propane 7nnx <br /> soap WWWAier 13arbago <br /> Can <br /> h�� !`}rak�dlni)ulnhel �xUn i <br /> ice Cooler h(}al Hnno WWI <br /> f-wn k:o&VY a frx annlnhare owl ha Y{,uiawgtar[all nlnnr <br /> ---- tiardd BlrifYras all n!lAe pmund! ' <br /> 1 B66 E. Hazelton Avenue I Siocltlon, Callfornla 06205 T 209-468.3420 lr 209 464-0t38 wwwrsj9ay.or'g1ehd <br /> END 16'02 Aaps_4.n11 i TEMP EVENT APP <br /> asl�sll� <br />