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SAN 1OAQUIN Environmental Health Department <br /> _COUNTY— <br /> t;rrntness rJru1Y5 hewn <br /> 10. 1 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 ❑Refrigerator <br /> ❑Refrigerated truck ❑ Ice bath and tubs <br /> ❑Other(specify) N/a for us <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. <br /> 12. 1 am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br /> booth: <br /> X Water supply dispenser with warm water at a minimum of 100`F(i.e.5-20 gallon container with spigot). <br /> Rone separate tub(bucket or basin)for the collection of rinselwastewater. <br /> xPaper towels and pump-style soap,container. <br /> 13. Names of responsible persons to be present in booth during all hours of operation: <br /> .]aVnq Casp.V Bret Casey <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 ev eR. <br /> 14. Completed by; owner 9/28/24 <br /> signature(/ Title Date <br /> 5-20 Gel. <br /> Health Permit Handwash Water <br /> atamowlG,arrktg <br /> dsh Paper Hand Towels <br /> Scrap diapenaer <br /> G�lting Board Saneizer buckel- <br /> bleach a water far <br /> Propane Stove <br /> Bleach storing vAping rlolhs <br /> Booth must be on <br /> Concrete,Asphalt, <br /> / - Plywood,or a Tarp. <br /> Propane Tank <br /> ------------ <br /> Soap and Water Rinse Water Bleach and Water Gar6agf <br /> Can <br /> Fire Exlingusher <br /> Extra <br /> 4Neter <br /> Ice Cooler 5Gal Hand wash <br /> F fra ke Bags 6 Food CoMe'nem must be Waalawaler CoMalnar <br /> stored 6 friaos off of The ground! <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br /> EHp 16-02 Page a or 11 TEMP EVENT APP <br /> 07,13117 <br />