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:�-`t ° SAN JOAQUIN Environmental Health Department <br /> �ar�` C0UNTY <br /> ef` r Greotness grows here_ <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 41OF temperature): <br /> Dice 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 /> M-betergent, bleach,and wiping cloths(cleaning towels). <br /> J21-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 /> later supply dispenser with warm water at a minimum of 100°F(i.e. 5-20 gallon container with spigot), <br /> "J!�One separate tub(bucket or basin)for the collection of rinse/wastewater. <br /> �Baper towels and pump-style soap container. <br /> 13. Names)of respon ble perspns to be preset in booth during',-2—"a s of operation: <br /> "*Important" AAllll 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 /> preparatio and ope Lion. Return oric3inal to festival-coordinator three weeks prior to <br /> thi ve )) <br /> 14. Completed by: <br /> ignat re -Title Date <br /> 5-20 cal. <br /> Health Permit H&W wash Water <br /> Stamo wChaffing <br /> Gish <br /> Paper HaM Towels <br /> Z_ — <br /> Sanitaw buckel- <br /> ble..h a waxerfw <br /> swung w�Png aolhe <br /> Booth must be on <br /> Concrete,Asphalt. <br /> Plywood,or a Tarp. <br /> SW and waver no"Water 9le60 W4 vftw Garbage <br /> Can <br /> fire EaFlnqureher <br /> En1n <br /> waxer <br /> ice Cooler MM <br /> 5Cd HOW wash <br /> 6"We!Ws a FOW C.onfeviers must 6o Wwwwalar caHanar <br /> swWBdes offal ftip md! <br /> 1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 I www.stcehd.com <br /> EHD 16-02 Page S of 11 TEMP EVENT APP <br /> OMM7 <br />