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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 /> 45OF (if food is used the following day, maintain below 41 OF temperature): <br /> crice chests ❑ Refrigerator <br /> ❑ Refrigerated truck, Ice bath/and tubs _ <br /> ❑Other(specify) G�il/IZJ <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 /> Q'Three deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br /> sot tion (one tablespoon of bleach per gallon of water). <br /> Detergent, bleach, and wiping cloths (cleaning towels). <br /> RTub 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 101)°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 /> 13. Names of resp nsible persons to be pre ent in bogth d all hours f operati . <br /> [a2o L � Z <br /> V <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 evT <br /> 14. Completed by: /d AD 0-5- <br /> Signature Title Date <br /> - .ws 5-20 cal <br /> Health Permit y Hand wash Water <br /> stern wlchaffrng <br /> Dish <br /> Paper Hand Fowels <br /> Soap dsspenser <br /> Cutting Board Sanitizer bucket- <br /> bleach&water for <br /> Propane Stove <br /> Bleach storing wiping cloths <br /> Booth must be on <br /> O Concrete,Asphait, <br /> Plywood, or a Tarp. <br /> Propane Tank <br /> soap and Water Rinse Water Bleach and Water Garbage <br /> Can <br /> Fire Extinguisher <br /> Extra <br /> Water <br /> Ice .11 5 Gal Hand wash <br /> I Fxtra Ice Bags 8 Food Containers must De Wastewater Gnntainer <br /> stored 6 Inches of of the ground; <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.orglehd <br /> EHD 16-02 Page 0 of 11 TEMP EVENT APR <br /> 07/01/2025 <br />