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or°J'� cG` SAN �JOAQUN p <br /> Environmental Health Department <br /> CQUNTY <br /> urs,r r _ <br /> `•t,,�aQs CJ'POinP55 Gr�wS '72'P <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"F temperature), <br /> S�ke chests ❑ Refrigerator <br /> ❑ Refrigerated truck ❑ Ice bath and tubs <br /> ❑ Other(specify) <br /> 11. 1 am�oviding the following items within my booth for the sanitary cleaning of food preparation utensil <br /> �hree compartment sink. <br /> 0� <br /> ❑ Three deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br /> �olution (one tablespoon of bleach per gallon of water). <br /> �etergent, 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 /> w <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-stVie soap container. <br /> 13. Names of res o sible persons to be present in booth during all hours of operation <br /> t fir— D 4"Important" All 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 /> prepara ' nd operation. Return on final to fes 'va] coordinator three weeks prior to <br /> In'S e� t. f_ <br /> 14. Completed by: �� t <br /> Signature Title Date <br /> 5.X Gal <br /> Hama wash water <br /> Health Permit Stetnew/Charhr6 <br /> Drsh Paper Nano 7pwels <br /> Soap dispenser <br /> Cutting Board bleach& 4tar for <br /> storing vAw9 dwhs <br /> Bleach <br /> Propane Stove <br /> Booth must be on <br /> Concrete,Asphalt. <br /> Plywood,or a Tarp. <br /> a <br /> _ "���.. __ F.,....-_ <br /> PropanJTank <br /> Soap and Water Rirse Water Bleach and Water Garbage <br /> f <br /> Can <br /> Fire Extinpurshar <br /> Enro <br /> water <br /> Ice Cooler r 5GalHandwash <br /> Extra tce Sags d food Gomlayiers must be <br /> Wastewater container <br /> srorea 6 inches olf of the ground, <br /> 1R68 E. Hazeiton Avenue I Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/ehd <br /> a r+a TEMP EVENT APP <br />