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SANAMUIN Einvironttien - <br /> —COUNTY tat Health Department <br /> r�r, <br /> Greatness grows lure. <br /> 10• 1 am providing the following cold temperature*ontrot for the*old holding of <br /> 45•F(If f00d Is used the following day,maintain below 41 bF temperate e): potentlatly hazardous foods below <br /> m ice chests .0 Refrigerator <br /> ig Refterated truck 0 ice bath and tubs <br /> Other(sp") - <br /> 11. 1 am:providing the following'Items within my booth for(he sanitary cle.anIng of food preparation utensil <br /> OR 0 free CoMpar'tment sink. <br /> XThree deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br /> so ution(One tablespoon of bleach per gallon of water), <br /> Detergent, bleach,and wiping cloths(cleaning towels), <br /> Tub to store wiping cloths in bleach solution. <br /> 12. € am ,providing the following for adequate hared washing facilities, but separate from utensil wash within my <br /> booth: <br /> Water supply dispenser with warm water at a minimum of 1007(i.e. 5-20 gallon container er with spigot). <br /> - i <br /> []Ohe separate tub,(bucket or basin)for the collection of rinsetwastewater. f <br /> 0 Paper towe'is and pumpgWe soap container. <br /> 13. Names o %ible perso s to be present in booth during all hpurs of operation: <br /> -Zpd 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 ail hours of <br /> preparation an pest' n, Rotdffl original to boo ato three weehasdor to y <br /> this event. <br /> 14. Completed.by: r 6 <br /> Signature Title D2% , <br /> SM c.r, <br /> i <br /> Health Permit ** <br /> r <br /> oash <br /> seep d�prrra.' <br /> rg garb aarifter W&Mt- <br /> slow MOM Madnp * daft <br /> Booth must to on <br /> Plywood,or a Tarp. <br /> M F1apandw" ROM Mnr Bea wNdIkMr <br /> can <br /> � Fla��1 Mar <br /> W"*r <br /> Ice Cooler = ac119�91*VOW% <br /> fxtn ks Be7a Q Frmd Gar,f.�r. n m��t 1e V�'�r Cat!r+kr <br /> OfOrd a��f w a�dlhs s <br /> 1868 E. Hazeiton Avenue Stockton, California 95205 T 209 463-34201 F 209 464-0138 I www-sjgov.or'g/ehd <br /> atn 1M2 rage a of 11 TEW EVENTAP'P <br /> MM1s <br />