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SA N 10AQ U f N Environmental Health Department <br /> COUNTY <br /> Jv <br /> Greatness grows here- <br /> 10. 1 am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> Aq°F (if food is used the following da,y, maintain below 41°F temperature): <br /> chests n Refrigerator <br /> Refrigerated truck Z1ce bath and tubs <br /> ❑ Other(specify)_ <br /> 11. providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> 71 Three compartment sink. <br /> OR <br /> �hree deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br /> so tion (one tablespoon of bleach per gallon of water). <br /> 10 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 /> Zd—Water supply dispenser with warm water at a minimum of 100'F (i.e. 5-20 gallon container with spigot). <br /> Z21-One separate tub(bucket or basin)for the collection of rinse/wastewater. <br /> 9paper towels and pump-style soap container. <br /> 13. Names of responsible persons to be ppresent in bootl�siuring 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 of this checklist must be in the booth at all hours of <br /> preparation 1�u eratio ReturV original to festival coordinator three weeks prior to <br /> this event. �. <br /> 14. Completed by: f <br /> Sign tore Title bate <br /> s-20 cat. <br /> Health Permit Hand wash Water <br /> 9temo wlChatfing <br /> Dish <br /> Paper Hend Towela <br /> Soap dispenser <br /> Cutting avvrd 3anitlzer buvkel- <br /> bleach&water for <br /> storing wiping dohs <br /> Pmp�e Stare <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> Proparc Tank - <br /> 1 Soap and Water Rinso Water Bleach and Water Garbage <br /> Can <br /> Fire Extinguisher <br /> Extra <br /> Wator <br /> Ice Cooler 5 Gal Hand wash <br /> Exha ice Bags&Food Conf&;Hers mvsf be - Wastewater Caniainar <br /> stored 6 inches off of the gmundt <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/ehd <br /> EHD 16.02 Page 8 of 11 TEMP EVENT APP <br /> 07101 r9n74 <br />