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S A N J Q A Q U I N Environmental Health Department <br /> COUN— , <br /> 10. 1 a2eproviding the following cold temperature control for the cold holding of potentially hazardous foods below <br /> °F (If food is used the following day, maintain below 41°F temperature): <br /> e chests ❑ Refrigerator <br /> ❑ Refrigerated truck ❑ Ice bath and tubs <br /> ❑ Other(specify) <br /> 11. I pding the following items within my booth for the sanitary cleaning of food preparation utensil <br /> Threerovi 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°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 responsible persons to be present in booth during all hours o€operation: 5tc��2$� .�12 <br /> S&vn �XC �- i <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 event. /� x <br /> 14. Completed by: WW_ 1 �C`C— _ l��I�I n(,t� UZ 3 <br /> Signature Title Date <br /> 5-20 Gal, <br /> Health Per Hand wash Water <br /> S!erno wlCheffing <br /> Dish <br /> Paper Hand Towels <br /> Cullinn Board SanlltZer GuCkei- <br /> blOaUt 8 wafer for <br /> Propane 5[ove Bleach slonng Wong cloths <br /> Booth must be on <br /> Concrete,Asphalt, <br /> e_yr Plywood, or a Tarp. <br /> Propane Tank <br /> Soap and Wa;cr Rinse Water Bleacr znd Wave: Garbage <br /> Can <br /> Fire Extmgwsher <br /> EMra <br /> Water <br /> Ce 6oFer A:7 .P-M 5 Gal Hand wash <br /> :;ra ICE Sags 8 Food Containers m4isl be WBSlevra:er COnlarnar <br /> sWr@d B:nChes off of the ground! <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/ehd <br /> EHD 16-02 Page 8 of 11 TEtv1P EVENT APP <br /> npren:�no� <br />