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S A N J Q QQ U I N Environmental Health Department <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 a ❑ Ice bath and tubs <br /> Other(specify) d U C } 2"22 t� <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 /> tipThree deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br /> olution(one tablespoon of bleach per gallon of water). <br /> Eff'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 /> Water supply dispenser with warm water at a minimum of 100'F (i.e. 5-20 gallon container with spigot). <br /> Wne separate tub(bucket or basin)for the collection of rinse/wastewater. <br /> [ffP2per towels and pump-styie soap container. <br /> 13. Names of responsible persons to be present in booth during all hours of operation: <br /> bo b <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 /> thi ant. <br /> 14. Completed by: r` 5y- �����aZ y <br /> Signature Title Date <br /> Health Permit HaMwashwaler <br /> SlernO wfGhBtfing <br /> oh <br /> Paper Hand Towels <br /> Soep cspeneer <br /> Cuttmp 9odfd Sanitizer budket- <br /> blearh a waterfor <br /> Propane$love 81Bacn aloring vApin0 dpths <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> PrOpale Tank <br /> Soap and Wa[er fLnse Walar HlBach and Water Garbage <br /> Can <br /> ri a Exlinquisher <br /> Ex[ra <br /> Watnr <br /> Ice Cooler s Gal xaed..aah <br /> Extra ke Begs d Food Conrakmrs must be Wa9tewater CanEainBt <br /> Nored 6 kwhas off of fhe gruaW! <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 j www.sjgov.org/ehd <br /> EH0 16-02 Page a of 11 TEMP EVENT APP <br /> 06/29f2023 <br />