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Environmental Health Department <br />10. <br />m. <br />OR <br />12. <br />tub (bucket or basn) for the coAedkxi of nnseAvastewaiei. <br />towefe and pump-slyte soap container. <br />hot^p tfop^fetion:13. <br />“Important** <br />Completed by: U. <br />Signature <br />Heath PemM <br />Rrmt M«n« Tomei <br />Breach <br />SsKnarMVOwr <br />Fts»esBr®aS» <br />TEMP EVENT APP <br />__frr <br />S lice Cooter I . jllL____Is <br />SnMarbudaC- <br />bteadi & waiar for <br />srertnQ dcihs <br />I am provK&rg the fofcwing tens my booth for the sanitary arearong of food ■prepa''353an uterasl <br />Q Three compartment sink. <br />^fhree deep lube (fcasm 6-8 bches mmwnwiw), one for soapy water,, one far rin®ng and one far a bfeadh <br />solution (one tablespoon of bleach per gaflon of water). <br />O Detergent Weach, and wiping doths (cleaning towels). <br /> Tub to store wiping cfcths sn bteach soMfon. <br />StemovChaSng <br />Otch <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />S^Vatsr supply dispenser with warm water at a minimum of 100°F (La. 5^20 gallon container with spigot). <br />resent in booth during all <br />Z/i/rreefr <br />Booth must be on Concrete-Asphatt. <br />P^wxrforaTirp. <br />s-aidsi. <br />Hnmf-MOS)VW»U»r <br />5 Gaf Hants mart <br />waimwaosr CantHtpor <br />SAN JOAQUIN <br />-----COUNTY------ <br />Git.'utne>s »).• vs h'it-. <br />I am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br />45’F (if food is used the folcwr^g day. maintain betaw 41 “F temperature); <br />chests Refrigerator <br /> Refrigerated truck Q foe bath and tubs <br /> Other (specify) <br />EflaMy»Mg^MK^.T TTJ. in*/ j <br />stored g Inches off of the ground! IJ <br />Title <br />Names of responsible persons to be <br />1858 E. Hazelton Avenue j Stockton, Catifomia S52051 T 209 468-3420 J F 209 464-0138 H www.s5cebd.com <br />EHD 16-02 Pafl® 8 of 11 TS^* EVEHT <br />M food vendor booths are subject to tnspecttoni Please make a copy of this applicator} in <br />preparation far foes event A copy of ffw checklist must be um foe booth at afll hoars of <br />preparation and operation. Return original to festival coordinator three weeks prior to <br />this event — <br />4-*g-~^ <br />Date <br />I PrapaneTank <br />| Pf^BwSBw <br />HEwavurer ? <br />2 <br />Garbage <br />I Cu«ngBcad |