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S A N J O A Q U I N Environmental Health Department <br /> I", <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 /> C� 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 /> ER 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 rinselwastewater. <br /> Paper towels and pump-style soap container. <br /> 13. Names of responsible persons to be present in booth during all hours of operation: <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: ti'�A I l-11I a s fzAI I -I �113 <br /> Signature Title Date <br /> -...-.' 5.20 Gal. <br /> Health Permit sterno w7Che Hand-ash Water <br /> ffing <br /> Dish <br /> Paper Hand Towals <br /> Snap di5pansar <br /> CuCing Board Saniuznr buCkeh <br /> hleedt 8 wa[af ror <br /> storkng wiping dping <br /> prapare Strove $Seam <br /> Booth must be Dn <br /> Concrete,Asphalt. <br /> Plywood,or a Tarp. <br /> Propane Tank <br /> Soap ano Waier Rinse Water Bleach and Waler Garbage <br /> Can <br /> Fire ExlingUlsher <br /> Ex[rn <br /> f - <br /> Ir ` <br /> i Ice Cooler a - - _-.:.,i;p,11'.I 1'' '" 5 Gal Hand wash <br /> Extra tce Sags&Food Cantainors musl be { Wastewatar Container <br /> - - stored 6 inches off o/the ground! <br /> 1868 F. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.orglehd <br /> EHd 16-02 Page a or 11 TEMP EVENT APP <br /> 07101/2024 <br />