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SA N 10 A Q U I N Environmental Health Department <br /> COI) N 1 Y <br /> i. <br /> 10. 1 am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 457 (if food is used the followin da maintain below 41°F femperature): <br /> ❑ Ice chests rigerator <br /> ❑ Refrigerated truck ❑ Ice bath and tubs <br /> ❑ Other(specify) <br /> 11. I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> ❑ Three compartment sink. <br /> OR <br /> ASQ�i <br /> hree deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br /> ion (one tablespoon of bleach per gallon of water). <br /> etergent, 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 /> Water supply dispenser with warm water at a minimum of 100*F(i.e. 5-20 gallon container with spigot)- <br /> -gone separate tub(bucket or basin)for the collection of rinselwastewater. <br /> Paper towels and pump-style soap container. <br /> 13. Names of responsible pets ns to be present in booth during all hours of operation: <br /> ""'Important" 0 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 /> reparation and operation. Return original to festival coordinator three weeks prior to <br /> t i event ++ "� <br /> 14. Completed by. <br /> Signature TiN Date <br /> 5-20 Gal. <br /> Health Permit Hand wash Water <br /> Stoma wlChafring <br /> D,Sh <br /> Paper Hand Toweis <br /> Soap dspensor <br /> CvlLnp Boerd Sann¢er bucrrel- <br /> bbxh A water for <br /> Propano Slo-+c <br /> Bleach starg wpu+g clarhs <br /> Booth must be on <br /> Concrete,AsphM, <br /> 0 Plywood,or a Tarp. <br /> Propane Tank Uot <br /> Soap end Watur RinseoCanl4smer <br /> r Garbage <br /> Can <br /> Fuo Ea4„awslier <br /> Ice Cooler ' I """' '^�""""'�"Extra kd Baps S Food Containers musr ba <br /> ---- slaved 6 mc"s off of rho groundr <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 F 209 464-0138 1 www.sjgov.org/ehd <br /> EHO 1"2 Page 8 of 11 TEMP EVENT APP <br /> 07/0112025 <br />