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S A N 10 A Q U I N Environmental Health Department <br /> COUNTY <br /> Greotness grows here. <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) <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 /> 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 /> ® Paper towels and pump-style soap container. <br /> 11 Names of responsible persons to be present in booth during all hours of operation: <br /> Jennifer Squier-Dew <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 event. <br /> 14. Completed by: Owner 9/16/25 <br /> ignature Title Date <br /> 5.20 Gal, <br /> Health Permit Sle Hand wash Water <br /> mo wlChartrng <br /> Dish Paper Hand Towels <br /> Soap dispenser <br /> Cutting Board Saritizar bULkat- <br /> bleach 8,water for <br /> Propane Slove Bleach storing wiping cloths <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp <br /> Propane Tank <br /> ,mac' Soap and Water Rinse Water Bleach and Water Garbage <br /> y� Can <br /> Fire ExLngutsher <br /> Extra <br /> Water <br /> Ice Coo 5 Gal Hand wash <br /> Extra Ice Bags B Food Containers must be Wastewater Container <br /> ----- stored 6 inches off of the groundl <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 ( F 209 464-0138 1 www.sjgov.org/ehd <br /> EHD 16-02 Page 8 of 11 TEMP EVENT APP <br /> 0710 1 <br /> /2025 <br />