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6.png <br />SAN JOAQUIN Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br />2J One separate tub (bucket or basin) for the collection of rinse/waslewater. <br />‘Important** <br />Completed by. <br />Pkx-- HbIVJ 'ortrtt <br />Garbage <br />Can <br />14. <br />S-TOGer <br />rta.vl Vi. - <br />Duh <br />I am providing the following cold temperature control for the cold holding of potentially hazardous foods beio* <br />45’F (if food Is used the following day. maintain below 41 f temperature): <br /> Ice chests JYRefrigerator <br />Refrigerated truck | J ice bath and tubs <br /> Other (specify) <br />I providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />. *J ~h'ee compartment sink. <br />Three deep ‘tubs (basins 6-8 inches minimum), eno tor soapy water, one for rinsing and one for a bleach <br />solution (ore tablespoon of bleach per gallon of water). <br /> Dete-gont, bleach, and wiping cloths (cleaning towels). <br />' ~ub to store wiping cloths in bleach solution <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash wm -n my <br />booth- <br />Water supply dispenser with warn-', water at a minimum of 100eF (i.e. 5-20 gallon container with spigot) <br />-Ice Cooter <br />13. <br />'| T 209 468-34201 F 209 464-0138 | www sjgov org'ehd <br />TEMP EvtNT APP <br />J 'J -'.ur. tAx.'Mr. <br />Mcu::- 4w«.v<tai I <br /><wrq c-pt- J <br />Sootti must to on <br />Concrete. Asphai’.. <br />Plywood. O' d Taro <br />------------J <br />sa7gc.*jy~-^~,'*'| <br />California 9-. < •: I <br />| Soap AMHKTMrr | ----------, \ <br />, EFEK <br />T^ra Oo <br /> I r-— 11 | <br />J J Gal »V»«J «.-U- — -------' <br />Raper towels and pump-style soap container. <br />.‘•James o' responsible persons to be present in booth during al> hours of operation <br />•j /-irvifcV’Uy ' -'T <br />AH fooTvendoTbooths are subject kTinspection Please make a copy of this application n <br />preparation foi 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 />_O^^.c.. <br />*1"' ^gnature Title Date <br />186fl £. I iazerion A-.'enue | Stocks <br />Health Permit