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S A N J O A g 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 /> 45'F (if food is used the following day, maintain below 41'F temperature): <br /> 12fice chests ❑Refrigerator <br /> ❑ Refrigerated truck ZrIce 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-a inches minimum), one for soapy water, one for rinsing and one for a bleach <br /> solution (one tablespoon of bleach per gallon of wafer). <br /> a0etergent,bleach, and wiping Goths(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 /> Q Water supply dispenserwith 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 /> dPaper towels and pump-style soap container. <br /> 13. Names of.responsible persons to be present in booth during all hours of operation: <br /> YIVI*N 17?*0 71?AN <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: 54. <br /> at re Title S-IO Go Date <br /> Health Permit Ham rmew,r. <br /> 5[crno r.+Cl+alfnp <br /> Pa Per HMa Twwia <br /> Soso daeenaer <br /> G�rirq edtl Umazer WctM <br /> o fad+t"ra1H 1w <br /> PIGPiM Sly.a <br /> &saes 9MM0 IAP-V Uov+t <br /> Booth must be on <br /> Concrete.Asphall, <br /> JUL ; 7 f Plywood.Of a Tarp. <br /> s+mopna Tdstr <br /> &4pA ana Wfllpr Rplp Water steed,a d W4*- Gafiage <br /> FreENuWlrsMr <br /> E n.p <br /> waur <br /> Ice Cooler `a wr'�jep ' SGarHMd watt <br /> Emp ire Bps d Food Canramers,,rust or weflrw w C 1&r <br /> Anred 6 Mches on of the 4MwhMar <br /> 1868 E Hazeiton Avenue I Stockton. California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br /> END 16.02 Page B 01 14 TEMP EVENT APP <br /> 071,y17 <br />