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SARJOANIN Environmental Health Department <br /> Z, r <br /> (Greatness (grows here. <br /> 10. 1 am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 45eF(if food is used the following day,maintain below 41 eF temperature): <br /> ❑ice chests ]Refrigerator <br /> ❑Refrigerated truck ]ice bath and tubs <br /> Other(specify) ,ryl <br /> 11. �I arc providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> Three compartment sink. <br /> OR <br /> ❑ 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 /> ,-solution <br /> bleach,and wiping cloths(cleaning towels). <br /> T]Tub to store wiping 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 /> xWater supply dispenser with warm water at a minimum of 100eF(i.e.5-20 gallon container with spigot). <br /> ❑One separate tub(bucket or basin)for the collection of rinse/wastewater. <br /> IV Paper towels and pump-style soap container. <br /> 13, eof responsible persons to be present in booth during all hours of operation: <br /> 5u1WIA-x (gffi) 5-0-a—&J"74 _, ... <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 /> preparation and operation. Return original to festival_coordinator three weeks prior to <br /> this event. <br /> 14. Completed by: W �U1Y1 �t <br /> Signature Title Date <br /> 5-20 Gal. <br /> health Permit hand waeb wafer <br /> Stemowtumf" <br /> t]ish <br /> Paper Rand Towels <br /> Soap dlapeneer <br /> Cutting Board aanit¢er bucket- <br /> bteaeh a water for <br /> Propane Slove Bie*eh acarrrtg wiping clans <br /> Booth must be on <br /> Concrete.Asphalt, <br /> Plywood,or a tarp. <br /> Prapane Tank <br /> soap and water fi"vtse water Bleach and wafer Garbage <br /> Can <br /> t � Fae Extinguisher <br /> { Exlsa <br /> � walar <br /> Ice Cooler 5Gal Nand wash <br /> E�drs!ce Raga d poaa C rd fir ra mute 6, W xstewrta Container <br /> stored B inches od of the groundl <br /> 1868 E-Hazelton Avenue I Stockton,California 95205 I T 209 468-3420 I F 209 464-0138 1 www-ejgov.org/ehd <br /> ENO 1"2 Page a of 11 TEMP EVENT APP <br /> 08I1$!13 <br />