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S A N )Q A Q U I N Environmental Health Department <br /> COUN-Y <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 /> &Kce chests ❑ Refrigerator <br /> ❑ Refrigerated truck ❑ Ice bath and tubs <br /> ❑Other(specify) <br /> 11. 1 an)providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> hree compartment sink. <br /> OR <br /> a 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 /> E�tDetergent,bleach,and wiping cloths(cleaning towels). <br /> `rub 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 /> ❑t Water supply dispenser with warm water at a minimum of 100°F(i.e. 5-20 gallon container with spigot). <br /> ❑"e separate tub (bucket or basin) for the collection of rinse/wastewater, <br /> [,Paper towels and pump-style soap container. <br /> 13. Names of responsible persons to be present in booth during all hours of operation: <br /> N'DZMVZ i�A A-G <br /> "Important" All food vendor booths are subject to inspection. Please make a copy of this application in <br /> preparation for this ev nt. A copy of this checklist must be in the booth at all hours of <br /> preparationVdoperdon. Return original to festival coordinator three weeks prior to <br /> this event. <br /> 14. Completed by: f aW K»2 ll J <br /> '-�-Sighwure Title Date <br /> 5-20 Gal. <br /> Health Permit Hand wash water <br /> Stemo wlchalting <br /> dish <br /> Paper Hand Toive{s <br /> Soap dispenser <br /> Cuffing Boartl Sanitize'bucket- <br /> bleach&water roc <br /> Propane Stove Bleach <br /> slonng wnping cloths <br /> Booth must be on <br /> Concrete.Asphalt, <br /> qq xr O Plywood,or a Tarp. <br /> . <br /> Prapanr.Tank <br /> Soap and Walet Rinse Water Bleach and Watpc Garbage <br /> Can <br /> Fire Extinpulsher <br /> Extra <br /> Walor <br /> Ice Cooler 5 Gal Hand wash <br /> EAlra Ice Begs d Food Containers must be Woslewale container '! <br /> stored 6 oxhes off of the ground! <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 T 209 468-3420 j F 209 464-0138 1 www.sjgov.org/ehd <br /> EhiD 16-02 Page 9 of 11 TEMP EVENT APP <br /> 07/01/2024 <br />