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S A N I Q A Q U I N Environmental Health Department <br /> C:Uuiw_TY <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 /> ❑ 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 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br /> s ution (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 /> ❑water 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 rinselwastewater. <br /> Ix Paper towels and lump-style soaa container. <br /> 13. Nam o fr s�ponsible rsar�s to be present in booth during all hours of operation: <br /> 1_ Olt <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 ope Return original to festival coordinator three weeks prior to <br /> this event. ^1 <br /> 14. Completed by: .. _ I 111 d _s <br /> 5"9xure Title Date <br /> 5-20 Gal, <br /> Health Permit Hand wash Wager <br /> Slemo wrCharflng <br /> oi-n <br /> P-dpar Hind To�+ah, <br /> Soap diapanavr <br /> CmhnO Board SaniWa'bncket- <br /> bingCh 6 VAOW for <br /> Propane Slnvu Bleach '2n,9 <br /> -ping clolhs <br /> Booth must be on <br /> concrete,Asphalt. <br /> Plywood, or a Tarp. <br /> PrOPBn9 TPgk <br /> ------------- <br /> Snap and Watn, Rnsn Warn. Mul"t,.nuf water Garbage <br /> Can <br /> Fira Extinguisher <br /> Erna <br /> wales <br /> FIceooler 5CW viand wash <br /> Extra!ce Sags 8 Foal Lorxanrers rrarsl be Wale"Wer Conlamer <br /> stored 6 orclrtxs oNd lho 1+�+,<+rn C� <br /> 1868 E. Hazelton Avenue Stockton- California 95205 T 209 468-3420 F 209 464-0138 1 www.sjgov,orglehd <br /> EHO 16-02 Page S of 11 TPMP EVENT APP <br /> 0710112025 <br />