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SAN 1UAQUIN Environmental Health Department <br /> —COU N 1 Y <br /> 10. 1 am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 45eF(if food is used the followin da , maintain below 41 OF temperature): <br /> ❑ Ice chests firigerator <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 /> Ascou <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 100eF(i.e. 5-20 gallon container with spigot). <br /> -gone separate tub(bucket or basin)for the collection of rinse/wastewater. <br /> ALPaper <br /> towels and oum style soap container. <br /> 13. Names of responsible pers 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 /> ftit event I. <br /> 14. Completed by: l <br /> Signature Date <br /> S20 Gal. <br /> Health Permit Hand wash Water <br /> Stereo wtChaffdn <br /> Dish <br /> Paper Hand Towels <br /> Soap dispenser <br /> Cum"9oard Saniazer bucket- <br /> bleach 8 water kw <br /> Propane Sro+p Bleach storng wqurg cloths <br /> Booth must be on <br /> Concrete,Asphalt, <br /> ;b 0 Plywood,or a Tarp. <br /> Propane Tank <br /> Soap and Water Russogn <br /> w Garbage <br /> Can <br /> Fao Eaanawshor <br /> Ice Cooler I Extra Jce&Vs 6 Food Containers must be <br /> arced 6 inches d/t of the groundr <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 7 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/ehd <br /> END 16-02 Page 8 of 11 TEMP EVENT APP <br /> 07/0112025 <br />