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S A N J O A Q U I N Environmental Health Department <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 T 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 5-8 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 /> ,&.,1Nater 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 rinsehvastewater. <br /> ,Paper towels and pump-style soar)container, <br /> 13. Vjmes of responsibl persons to be present in booth during all hours of operation: <br /> Wavlaino <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 /> Yk <br /> this event. +� <br /> 14. Completed by: (\ V t. a ��lt►�Y�o 2- <br /> T � Signature Title ate <br /> s•ao c., <br /> .t-EealthTPermit{ Ha�dwuns':atcr <br /> �'� Parer YWrA TGue:s <br /> C�ttriC deanl Sa+il4tlr OIGM[t` <br /> hlsdG L water tar <br /> ulsYt 5'rrtng Mrp,r9 CCtt`b <br /> Pr�D,;.e SL7.e <br /> Booth must be on <br /> O concrete,Asphalt. <br /> Plywood,or a Tarn. <br /> Ptzwft T3:'14 <br /> SG'U dnC 143:.'! Rr.[+::4 f:rd e'.edcn ani Wa!dr <br /> Garoage <br /> Can <br /> F.c Erhrqur_n:r <br /> Exira <br /> 4'J,�• <br /> Ice Cooler 5Gall Ma::U want <br /> 1;rlra La 8 y.6 F.w7 C✓:f�mris rux!De :'J�s:en:ater Car,G nee <br /> . sL:rvli,xcnes r'n/ihr rrraira' <br /> 1$68 F Ha'Pllon Avenue I Stockton. 1::ihtr rni2 5205 1 T ':j4'+:i8-34 Cr i F �}u,.�h �3r.Lh.s rGu <br /> EHD 16-02 Page 8 of i i TEMP EVL-NT APP <br /> 07017 <br />