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r <br /> S A N J O A Q U I N Ekivironn-iental Health Department <br /> COUNTY <br /> -'rr:r�5'1"` l,rlpfflr'.Si rfrVtS'S lle°rC. <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 /> ®Detergent,bleach,and wiping cloths(cleaning towels). <br /> E�"rub 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 1009F(Le, 5-20 gallon container with spigot). <br /> ®One separate tub(bucket or basin)for the collection of rinselwastewater. <br /> EJ Paper towels and pump-style soap container. <br /> 13. Names of responsible persons to be present in booth during all hours of operation: <br /> Boun Ouk &-Emily Ouk <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. <br /> 14. completed by: _ Sole Business Owner 4/4/2025 <br /> Signature Title Date <br /> 5-20 Gal. <br /> Health Perini HandwashWaler <br /> slema i,/c!,&IIYa <br /> U Sh <br /> Paper Hand Towels <br /> Soap dspenser <br /> CeAiirp 8oartl Sa,ellzerEw,l,et• <br /> roach 6 water for <br /> Propane Sloie Bleach stormy w�ping cloths ' <br /> Booth must be on <br /> r— Concrete.Asphalt, <br /> 4 ``* z Plywood:ar a Tarp. <br /> ra.; �.,. <br /> Propane Yank <br /> ------------ <br /> Y soap and Watei HinseWater flleachandwaW Garbage <br /> Can <br /> `---- //— FUe rxtingursber <br /> Fee. o e� 5 Gal Hand wash <br /> - Errra Ica Begs 3 Food Gonlafners must be Wastewater GonWftaf <br /> ararod G f hl)s W1of fha ground? <br /> i <br /> 1868 E. Flazelton Avenue I Stockton,California 952051 T 209 468-34201 F 209 464-0138 1 www.sjcehd.com <br /> EHD 16-02 Page 8 or 11 TEMP EVENT APP <br /> 0713117 <br />