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SAN JOAOOIN <br /> 10. 1 am providing the following cold tornperature contro4 for the;old holding of potentialty hazardous foods below <br /> 451F(if food is used the fallowing day,maintain botow 41"F temperature), <br /> ❑Ice chests <br /> Refrigerator <br /> ❑Refrigerated truck �� ��e�� <br /> ubs <br /> ®Other(specify) <br /> 11 1 am providing the fallowing items within my troth for the sonitary cleaning of food preparation utensil <br /> �Three compartment sink. <br /> OR []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 pef gallon of water). <br /> ❑Detergent,bleach.and wsping cloths(cleaning towels). <br /> ❑Tub to store Aliping cloths in bleach solution <br /> 12 1 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(i.e.5-20 gallon container with spigot) <br /> ❑One separate tub(bucket or basin)for the collection of rinse/wastewater <br /> ❑paper towels and DumR-Style soap container. <br /> 13 Names of responsible persorp to be present in booth during all hours of operation- <br /> "Important' AH food vendor booths are subject to inspection, Please make a copy of this applicat in <br /> preparation for this event. A copy of this ;-hecklist must be in the booth at all hours of <br /> preparation and operation Retum on Inal to festival coordinator three weeks prior to <br /> this event. <br /> 14. Completed by ^^ 7i Ve D <br /> Si nature <br /> sp rr <br /> ern,a.w,vgrr <br /> Health Permit <br /> n;� � vavar�a+a Tv.e+ <br /> S�nsc«rux <br /> 5.w,yr euOap <br /> Gww7 B� oraar3r a over tar <br /> B�eufi <br /> propane&are <br /> =., <br /> Prpmo TrM <br /> Gaup&m W81rx Rama Walar BIa3411 and Warty (',ar93gB <br /> Can <br /> u Ieb Fsru>;rreea <br /> Eetra <br /> � waAar <br /> ICe COQIet _- �vr.<_:• s=,.+s:, 6U Hand w6sh <br /> Fxlfa hN EO!ie 6 FooR:aererrwrs moor G* wpflaMraltlY Cunlnlnel <br /> arxa'}E r>7a�5 a7:n`Vo gmurYl' <br /> �;,AMI,r I � 46Z iEMV'EV17frS All <br /> Page 8 of 111 <br />