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I <br /> f , <br /> S A N J O AU U I N Environmental Health Department <br /> r ' <br /> S <br /> 10 l am providing the following cold lemperature control for the cold holding of polonlinily hazardous foods below <br /> 45'F(if food is used the following day,maintain below 41'F lempe(aturo): <br /> � c thesis [_J[Refrigerator <br /> Refrigerated truck [ Ice bath and tubs <br /> L]Other(specify) <br /> 11 1 am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> OR U Three comparimont sink. <br /> f <br /> hree 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 /> U 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 /> eutter supply dispenser wilh warm water at a minimum of 100'>=(i.e.5-20 gallon container with spigot). <br /> Rt'no separate tub(bucket or basin)for the collection of rinsehvaslewater, <br /> [paper towels and puma-styla soap container. <br /> 13. Names of responsible rsons to be prc e t in b olh ring all hours of operation: <br /> r-1 ew, <br /> "Important" All food vendor booths are subject to inspection. Please make a copy of this application in I <br /> preparation for this event. A copy of this checklist must be In the booth at all hours of <br /> I preparation and operation. Return original to festival coordinator three weeks prior to <br /> + thi event <br /> 14. Completed by: Z-1- <br /> Signal TItio Date <br /> a*a c■. <br /> Health Permli rMey w■-, <br /> s,.rno,.rcu,rcr,o <br /> P■per H.n6 ioxd. <br /> 6oap dnp■mer <br /> �; Wik.f aparp 8■nn.n Mrcke7- <br /> 1 x.,,6 w■er for <br /> ' pn,73^a Slo.a al■ath iwna oipN rlelhl <br /> �I Booth must be on <br /> O Concrete,Mphall, <br /> II) Plywood,or a Torp <br /> o,cd■nr 9 <br /> l <br /> R.I.W.I. aka-,and Wale, I Garbage <br /> Can <br /> � fr■[rknuw/he+ <br /> I Erna <br /> twater <br /> Ice Cooler a Met".-d—h _. <br /> f•Na![e page 6 foo0 ConfaMra ewal f+e Waklm.7ls,Caear,e, <br /> aM,o-16+„rhnf Wr d rM prIX+rd, <br /> r 1 f36f3 F.Has(aton Avorlurr l Slucklon.CMilo im 952.05 T 2013 468.3420 f 1: '209 464-0138 1 www.sjgov.anlrr.-hd <br /> Oil)1rr02 Pago b of 11 TEMP EVENT APh <br /> eG!19l9 9 <br /> r tit rr,arrerrTlriiirtIrTrrtrrJlfitwirrilaI Mill If Will 1'1IfIfT fill trfrrrll;sfrrrlrrr�r�rr;ti��[1i7T1!Ri f[7f1iIFlIff�T71'.lilfrt7T111nirrtirrr <br />