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! <br /> <br />Environmental Health Department <br />i <br />10. <br />i <br />12. <br />13.'X <br />14. <br />Paper Hand Tcwels <br />CUtnj Eojrd <br />1 <br />1 <br />I tlteadi <br />’SWater supply dispenser with warm water at a minimum of I OUT (i.e. 5-20 gallon container witli spigot). <br /> One separate tub (bucket or basin) for the collection of rinse/waslewaler. <br />SI<r>»wJCti<lK‘>0 <br />Oili <br />Gaibngo <br />Can <br />Booth must be on <br />Concreto. Asphalt, <br />Plywood, or a Torp. <br />I <br />1 <br />i <br />T1; ‘ /^) <br />Lxi Cf-CCA (a ( <br />SmifrcrtacAct- <br />ti'jaUi S <cr <br />MOrir^Wrinjdo’Ju <br />5^ ? <br />Waler. / I JU <br />• r——--------------------- <br />•6001114^^:1) <br />VMu.'r.vi’dr CcAii'nor <br />Health Permit I <br />Naves of responsible ------, <br />‘’Important** <br />■ PKpwoTank J • / / <br />SwpojxlWbior nh-.o W*« j <br />'....... C) <br />I--1 <br />IlWi j iiiOBi [ I...------ -.■ ■■ ilv^SM^cJlo/Vioo^nll J 1. <br />. ’ i o. r. ; n or •' omar! :’■ ' h~" 1 O'—I-'-’ , I <br />cv.-V <br />j prcpeiM Sto-.n <br />£5>Paner towels and pump-style soao container. <br />N^res of resptjnsi^ persons jo be in bo^l^uri<tg^al|hours of operaliyn; <br /> <br />AH 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 /> <br /> o— calulz <br />^^7 feature Title Date <br />i-50 Gil <br />«- UanJwowWiior <br /> j Soapifaptwr j ■■— \ <br /> <br />(reach .iixJVWer <br />11. J yi providing the following items within my booth for the sanilaty cleaning of food preparation utensil <br />Mlhree 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 />u Tub to store wiping cloths in bleach solution. <br />I am piovidmg the following for adequate hand washing facilities, bul separate from utensil wash within rny <br />booths <br />SAN JOAQUIN <br />COUNTY- <br />r . • ■ . . ..•. 1 <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 following day. maintain below 41 °F temperature). <br /> Ice chests W^efrigeralor <br />O Refrigerated truck Ice bath and tubs <br /> Other (specify)_—------------------------------------------------------ <br />1868 E. HazelionAveniie rs.locklon, California 95205 | T^MO «8.342O | F 209 4B4-0138 I mw.sjcehd.corn <br />wi?0' <br />J#......... low <br />A" n '■■■?