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Xk <br /> SA N .J OAQ U I N Environmental Health Department <br /> COUNTY <br /> Greatness grows here <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 /> U 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 /> N 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 rinse/wastewater. <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 /> r;irinc;btariac!Maria Pennlrna <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: ' `'= nwnPr <br /> Signature Title Date <br /> 5-2o Gal. <br /> Health <br /> Hand wash Water <br /> Permit <br /> Sterno wfChafing <br /> Dish <br /> Paper Hand Towels <br /> Soap diSpenSEr <br /> Cu1Gnp Board Sanitizer bucket- <br /> bleach&water for <br /> Propane Siove <br /> Bleach storing wiping cloths <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> Propane I ank <br /> Soap and Water Rinse Watcr Bleach and Water Garbage <br /> Can <br /> Fire Extinguisher <br /> F�dra <br /> Water <br /> Ice Cool el 5 Gal Hand wash <br /> Extra fca Bags&Food Gonfalners must be Wastewater Container <br /> stored 6 inches on of the ground! <br /> 1868 E. Hazelton Avenue E Stockton, California 95205 j T 209 468-3420 F 209 464-0138 1 www.sjgov.org/ehd <br /> EHD 16-02 Page 8 of 11 TEMP EVENT APP <br /> 07/01/2024 <br />