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S A N J U A Q U I N Environmental Health Department <br /> ---COUNTY <br /> t,l eillnCS. Iri nt';ti 1trt, . <br /> 10. 1 am providing the following cold temperature control for the cold holding of potentially haZar'CIOUS foods below <br /> 45°F(if food is used the following day,maintaln below 41 aF temperature): <br /> ❑Ice chests 1�( ❑Refrigerator <br /> ❑Refrigerated truck `J ❑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 /> 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. 1 <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 rinselwasiewater. <br /> ❑Paper towels and pump-style soap contalner. <br /> 13, hfarnes of responsible persons to be present in booth during all hours of operation: <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 operation. Return original to festival coordinator three weeks Prior to <br /> this event. <br /> 14. Completed by: <br /> Signature Title Date <br /> Health Permit I1anJ vrash Walor <br /> Slemo wlChafflnq <br /> ash Papar Hind Towals <br /> Soap dispenser <br /> CW tinq Baerd S enblzer bucket- <br /> bleach a water for <br /> Propeno Slone <br /> Mach storing vAping daths <br /> "oath must bo on <br /> O Concrete.Asphalt. <br /> Plywood,or a Terp. <br /> Propene Tenk <br /> Soep and Woter RinBe Water Hlearh anU Water Garbage <br /> Can <br /> Fira EMtinguleher <br /> Eklfa <br /> r� Water <br /> Ice Cooler — — LGel Handwesh <br /> Extra ke asQeeraOd Canlelnera marl 8e `I W5 Gal lerdiyash of <br /> ----------- slorodehiches all of lho prowldl <br /> 1868 E. Hazelton Avenue Stockton, California 95205 J T 209 468-3420 1 F 209 464-0138 l www.sjcehd.com <br /> EHO 10.o2 Page 0 of 71 TEMP EVENT APP <br /> 07Y3117 <br />