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SAN 1JOAQUIN Environmental Health Department <br /> =j 1 i1 {o'ikv�n i c old tcf;;l ,r;�tlJaB control for the cold holding of poterii.illy hazardous foods below <br /> u8(-'d the foiloW;ng clay, maintain below 41"F temperature): <br /> Reuigerator <br /> 'uCI" k.n hath and tubs <br /> the following iterns within my booth for the sanitary cleaning of food preparation utensil <br /> t l l.Cc- Colrriowirriont sink. <br /> t'_bs (basins 6-8 inches minimum), one for soapy water, ono for rinsing and one for a bloach <br /> 9l a l'--lo tablespoon of biesch per gallon of water), <br /> v 4. bleach,and W011 l cloths(cleaning towels). <br /> !� o t sole\,npinq,cloths in bleach solution. <br /> '• r Pr&oulmg the following for adequate hand washing facilities, but separate from utensil wash within my <br /> !` •'-:ttur sural:iy 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 /> E P'jp:-towels and pump-stvie soap container. <br /> 13. Names of responsible persons to be present In booth during all hours of operation: <br /> "Important" All food vendor booths are subject to Inspection. Please mftke a copy of this application in <br /> preparation for this event. A copy of this checklist must he 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. C,ompletec b : hisent. /i-- d 4Ju =a q h 3 2L <br /> Signature Title Date <br /> 6-?0 Oel, <br /> Health Permit Band WaSh Walar <br /> Gtano*<Chaffvkg <br /> D;sh puvar Nand Towais� <br /> 3osp 4'spsnser <br /> .':ssi:ra OoeA Ssnplxet 6ockal- <br /> Nea[h 3 wales for <br /> Dtuarh storing wiping cklns <br /> Booth must bo on <br /> t Concrete,Asphalt, <br /> n - ` Plywood,or a Tarp. <br /> Soap nn_. rv. fi ne'h'oler Hlanch a:uf'Nato, <br /> . ` Garbage <br /> Can <br /> f ko(N.inp.3shar <br /> £x7ra <br /> ff wialar <br /> ElcCoo�Br 50a1 Nand w-1 <br /> t nra Ice Bags d Focd rontaB-.em nsnl Ca Wpsi walar C"O!n- <br /> s:srnQ d-echo s sg or ilia gmwd� <br /> 8 E. Hazelton Avenue j Stockton, California 95205 j T 209 468-3420 j F 209 464-0138 1 www.sjgov.org/ehd <br /> No 16 02 Page as of 11 TEMP EVENT APA <br /> nn„o <br /> 186,.nn <br />