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SANJOAQUIN Environmental Health Department <br /> -----COUNTY— <br /> 10. 1 am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 45'f(If food is used the following day,maintain below 41'F temperature): <br /> Ice chests ❑Refrigerator <br /> ❑Refrigerated truck ❑Ice bath and tubs <br /> ❑Other(specify) <br /> 71. I am providing the following Items within my booth for the sanitary cleaning of food preparation utensil <br /> ❑Three compartment sink. <br /> OR <br /> Z Three deep tubs(basins 6-8 Inches minimum),one for soapy water,one for rinsing and one for a bleach <br /> Solution(one tablespoon of bleach per gallon of water). <br /> 12 Detergent,bleach,and wiping cloths(cleaning towels). <br /> Tub to store wiping cloths in bleach solution. <br /> i2 I 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 100'F 0.e.65-20 gallon container with spigot), <br /> a0ne separate tub(bucket or basin)for the collection of rfnsefwastewater. <br /> f .Paper towels and umsoap container. <br /> 13. Names of responslble p ns to be present in booth during all hours of operation: <br /> C �+ <br /> "Important" All food vendor booths are subject to Inspection. Please make a copy of this application in <br /> preparation for Is a ent. A copy of this checklist must be In the booth at all hours of <br /> reparation and per n. Return v Inal to festival ordinstor ree weeks rior to <br /> I eve <br /> 14. Completed by. '5\ Z <br /> gnatu Title ate <br /> axe o.� <br /> Health Permit Huf°"''fWi°� <br /> 7wma a <br /> SOi7�p•nar �ti kVan•T•.•w <br /> c�ena sera swam prtME <br /> wop. eM,a, ,mhq wpy d•o. <br /> Booth must be on <br /> Conmle,AspnnR <br /> Plywood,or a Tarp. <br /> FWr Trk <br /> ''"'� So•p rN W-W Pon"Wa W 91•dl rd W W <br /> Garbage <br /> �•r�ir,r <br /> Can <br /> n <br /> Ir� <br /> 1c9 Cooler 6 n•lirW wih <br /> Fvu'•d f+ct,k�and an pw.wl�r+MW M W <br /> —� J ru W"Cay.vir <br /> 1858 E.Hayeltori Avenue( Stockton,California 05205 1 T 209 46"420 F 209 464-0139 1 www.sJgov-orgland <br /> FNO M112 <br /> eIlO1R07A P•p•apr 11 TEMP EVENT APP <br />