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S A N J O A Q U I N Environmental Health Department <br /> COUNTY <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 OF temperature): <br /> 6I ce chests ❑ Refrigerator <br /> ❑ Refrigerated truck ❑ Ice bath and tops <br /> ❑Other(specify) i <br /> u <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°l= (i.e- 5-20 gallon container with spigot). <br /> One separate tub(bucket or basin)for the collection of rinse/wastewater. <br /> 92'11'aper towels and pump-style soap container. <br /> 13. Names 9f response le/persons to be present in booth during all hours of operation: <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 t. <br /> 14. Completed by: D` ZZj lJ ZdZS <br /> Signature Title Date <br /> &20 Gal <br /> Health Permit Hand wash Water <br /> Slerno wlGriafting <br /> Dish <br /> Paper Hand Towels <br /> Soap dispenser <br /> CUt11nR Boerd Sann¢er bucket- <br /> bleach&water for <br /> Propane Stave <br /> Wooch storing wiping clolhs <br /> Booth must be on <br /> Concrete,Asphalt, <br /> <' Plywood,or a Tarp. <br /> ProPam Tank <br /> Soap and Water Rmse Wa[nr Bleach and Water Garbage <br /> Can <br /> Fire Extinguisher <br /> Extra <br /> Water <br /> FIceooler I J 5Gal Hand wash <br /> Extra ke&Vs&Food Containers must he VYaslewalot Container <br /> —� stored S inches off of the ground? <br /> 1868 E. Hazelton Avenge I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov org/end <br /> EHD 16-02 Page B of 11 TEMP EVENT APP <br /> 07/01/2025 <br />