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l„ <br /> S A N�]0 A Q U I N Environmental Health Department <br /> --COUNTY <br /> (,Ivailless tjrulvs hele. <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 /> 11. 1 am 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 /> ❑Detergent,bleach,and wiping cloths(cleaning towels). <br /> ❑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 /> ❑Water supply dispenser with warm water at a minimurn of 100aF(i.e.5-20 gallon container with spigot). <br /> ❑One separate tub(bucket or basin)for the collection of rinselwastewater. <br /> ❑ Paper towels and pump-style soap container. <br /> 13. lames of rasp ible persons to be present in booth during all hours of operation: <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 /> th'-event. rr/ <br /> 14. Completed by: � !� t1C/ -C7-Z�. <br /> Signature Title Date <br /> 5-20 031. <br /> Health Permit HandwashWaler <br /> Slerno wlCham�g <br /> Dish <br /> Paper Hand Trntiols <br /> Scrap d'spenser <br /> CuWnp Board Sanldzer buckal- <br /> bleach It wale"for <br /> Propano Stove Bleach sloring wiping c"hs <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> Propane Tank - <br /> Soap and Water R!nse Water Bleach and water Garbage <br /> Call <br /> Fire Exdnpulsher <br /> Extra <br /> Wale" <br /> Ice Cooler SGal Hand wash <br /> Extre Ice Bags d food Confaklers nxuf be Wasbxvalor Conlolner <br /> stored 6Inehes off of the ground? <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 T 209 468-3420 F 209 464-0138 1 www.sjgov.org/ehd <br /> EHD 16.02 Page B of 11 TEMP EVENT APP <br /> 06119/19 <br />