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oP°U!a e <br /> S A NJ 0 A Q U ! N Environmental Health Department <br /> � ;.�� `) COUNTY <br /> Greotl 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 OF temperature): <br /> Ef 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 /> 0Three compartment sink. <br /> OR <br /> 0 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 /> C3110, ne separate tub(bucket or basin)for the collection of rinsetwastewater. <br /> VIP' <br /> aper towels and pum -s le soap container. <br /> 13. Names of respons. le ersons to be present in booth during all hours of operation: <br /> ID d - 2,0 --L/ <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 operatiom Return original to festival coordinator three weeks Drior to <br /> this event. �J L <br /> 14. Completed by: &a4&Z,f.tlt7i_ 16` — WZj <br /> Signature Title Date <br /> 5-20 Gal. <br /> Health Permi t Hand wash Water <br /> Stamo wlCheff ng <br /> Dish <br /> Paper Hand 7ovreis <br /> Soap dispenser <br /> Cutting Board Sanetizer bucket- <br /> bleach$water for <br /> Propane Sloe Bleach storing wiping cloths <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> Propane Tank <br /> Soap and Water Rinse Water Bleach and Water Garbage <br /> Can <br /> Fire Extinguisher <br /> Extra <br /> Water <br /> Ice Coole f 5 Gal Hand wash <br /> Extra Ice Bags$Food Containers must be Wastewater Container <br /> stored 8 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 S of 11 TEMP EVENT APP <br /> 07/01/2025 <br />