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Av�6 <br /> ` AAHON Environmental Health Department <br /> UIQ� ` 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°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 /> 0 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 /> 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 /> [r Paper towels and pump-style soap container. <br /> 13. Names of responsible persons to be present in booth during all hours of operation: <br /> L1 oG137 3 - :5 <br /> **Important** All food vendor bocfthIs 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 l2rior to <br /> this event. <br /> 14. Completed by: r 1 J ,f-202_-('� <br /> Signature Title Date <br /> 5-20 Gal <br /> Health Permit Hand wash Water <br /> Stems wlChaffing <br /> Dish Paper Hand Towels <br /> Soap dispenser <br /> Cutting Board Saniozer bucket- <br /> breath&water for <br /> Propane Stove <br /> Bleach storing wiping ctoths <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 Etlir'l 'rher <br /> ";E.' L Ezlra <br /> s <br /> ice Cooler , 5 Gal Hand wash <br /> . Extra Ice Bags d Food Containers must de wastewater Container <br /> -- stored 6 inches of!of the groundl <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/ehd <br /> EHD 16-02 Page 8 of 11 TEMP EVENT APP <br /> ncmninnn1 <br />