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S A N J O A Q U I N Environmental Health Department <br /> — c0I_Jr.:- <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 W-ceze'r5 <br /> ath and tubs <br /> nn'' '' o <br /> MOther(specify)CA -111161rCi C `-'? <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 /> 10 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 /> rVWater 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. ames of responsible persons to be present in booth during all hours of operation: <br /> e nn P? �_()Ky IZ- <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. 4' V � r <br /> 14. Completed by: 0 ' Q Vic, ti L /CiIU)TI f , q• 21'---;Kl— <br /> Signature Title Date <br /> 5-20 Gsd. <br /> Health Permit -' Hand wash Weler <br /> Stems wlChafr�ng <br /> Dlsh <br /> Paper Hand Towels <br /> Scap dispenser <br /> C Atinp eoerd Sa 111"hvdcet- <br /> Cloa�8 water for <br /> Propane Stove Bleach <br /> storing wptng doths <br /> a I Booth must be on <br /> O Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> Qror�ne 9 <br /> -------------- <br /> Soap and Water Rinse Water Bleach and Water Garbage <br /> Can <br /> Fva tKOnauisner <br /> Extra <br /> ` YJalar <br /> I J �'` <br /> i Ice Cooler 5Gal Hand wash <br /> Ehre Ice ggg5 6 Food Cwtaenars must be W nstn—ler Container <br /> - - srored 6Inches orf of Ma prpmCff <br /> 1868 E. Hazelton Avenue Stockton. California 95205 T 209 468-3420 1 F 209 464-0138 € www.sjgov.crgrohd <br /> EHD 1&02 Page 9 of 11 TEMP EVENT APP <br /> M0112024 <br />