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S A N J OA Q U f N Environmental Health Department <br /> C0LJN <br /> 10. 1 am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 45eF(if food is used the following day, maintain below 41'F temperature): <br /> [ <br /> ❑ice chests n'refrigerator <br /> ❑Refrigerated truck ❑ Ice bath and tubs <br /> ❑Other(specify) <br /> 11. �11 am��roviding the following items within my booth for the sanitary cleaning of food preparation utensil <br /> I�'I•hree 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 /> _1 dater 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 /> Doper towels and up mr3-style soap container. <br /> 13. Names of responsible persons to be pr sent in booth during all hours of operation: <br /> 'b U `> <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. Retum original to festival coordinator three weeks prior to <br /> this event. <br /> 14. Completed by: e <br /> Signatur Title Date <br /> 5-20 Gal. <br /> Health Permit Hend wash Water <br /> Stemo wlCnsrting <br /> Dish <br /> Papar bald Towels <br /> Soap dspertser <br /> Cutling Board <br /> LAME <br /> Propane Stove Bleach <br /> Booth must be on <br /> O Concrete,Asphalt, <br /> Plywood,or a Terp. <br /> Propane T" <br /> Soap and Water Rinse Weler arh and <br /> Welar Garbage <br /> Fire Ettlngueher <br /> Can <br /> F_tera <br /> water <br /> ;cel6oer I - <br /> . B Gal Hand wash <br /> t Edra Ace Hop d food Cattakmn muat be Wwteweler container <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 F 209 464-0138 1 www.sjgov.orglehd <br /> EHo 16-02 Page 9 or 11 TEMP EVENT APP <br /> OBI D119 <br />