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Oct 01 18, 04:46p p.3 <br /> r , <br /> S A N J D A Q U 1 N Environmental Health Department <br /> -- CO'J TV <br /> 10. I am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 4 °F (if food is used the following day, maintain below 41 OF temperature). <br /> lce chests Refrigerator <br /> ❑ Refrigerated trick ❑ Ice bath and tubs l <br /> ❑ Other (specify) <br /> 11. IW providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> hree 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 /> ,JRWater supply dispenser wish warm water at a minimum of 100'F (i.e. 5-20 gallon container with spigot). <br /> I a e separate tub(bucket or basin) for the collection of dnse&vastewater. <br /> Paper towels and pump-style soak container. <br /> 13. Names of responsible persons to be present in booth all urs of oper o � U� <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 a d o on. Return original to festival coordinator three we ks Prior to <br /> this event. G ` I :/l.r lQ <br /> 14. Completed by: <br /> S gnature itle Date <br /> s•2o eel <br /> �� Fond wash waver <br /> Health Permit <br /> 51erno rNChalttng <br /> prsh Paper Hand Towe <br /> Soap disDenser <br /> buckel- <br /> C�!ti8 Eioard bleaoh Sr-.Vatw ror <br /> storing wiping Goths <br /> OJoach <br /> Prnpa ne Strne <br /> Booth must tie on <br /> Concrete.Asphalt, <br /> Plywood,or a Tarp. <br /> Prepaae Tznk <br /> -- Soap and Water l2tnse;Na!e: bleach and Water Garbage <br /> Can <br /> Fre Edmgtflshpr <br /> �ttra <br /> udatcr <br /> rice 6o01er i Y 5 gal Hanc wass <br /> i _ -�__ Esfra lae bags&mood Carta Rers mr:c:tlr WasCewaler Ga^ta'net <br /> --'----- ata-ed 6 rnehos ar/af fre�rpundr <br /> 1868 E. Hazeiton Avenue Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd_com <br /> Received Time Oct. 1, 2018 4: 46PM No, 4195 <br />