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Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />Soap and Water Rinse Water Bleach and Water <br />Cutting Board <br />Propane Stove <br />Soap dispenser <br />r <br />ice Cooler <br />Fire Extinguisher <br />Extra Ice Bags & Food Containers must be <br />stored 6 inches off of the ground! <br />5 Gal Hand wash <br />Wastewater Container <br />• <br /> <br />SANdOAQUIN Environmental Health Department <br /> <br />COUNTY- <br />110.'r• <br /> <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 0 Refrigerator <br />0 Refrigerated truck 0 Ice bath and tubs <br />0 Other (specify) <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />0 Three compartment sink. <br />21 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 />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />12 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 rinse/wastewater. <br />&I-Paper towels and pump-style soap container. <br />Names of responsible persons to be present in booth during all hours of operation: <br />-Sose <br />OR <br />**Important" <br />14. Completed by: <br />Health Permit <br />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 />Signature Title Date <br />5-20 Gal. <br />Hand wash Water <br />Stemo w/Chaffing <br />Dish <br />Paper Hand Towels <br />Sanitizer bucket- <br />bleach & water tor <br />storing wiping cloths <br />Garbage <br />Can <br />,tr" caa)e Cr,thlet' <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sjgov.org/ehd <br />EHD 16-02 Page 8 of 11 TEMP EVENT APP <br />08/29/2023