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S A N J O A Q U I N Environmental Health Department <br /> COUNTY <br /> Greatness qrows 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 ;K1 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 /> ❑ 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 /> 29 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 /> EN Paper towels and pump-style soap container. <br /> 13. Names of responsible persons to be present in booth during all hours of operation: <br /> DAVID LOVE AND /OR JAKE BRAJEVICH <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: manager 3/5/2026 <br /> Signature Title Date <br /> 5-20 Gal. <br /> Health Permi t <br /> Water n Hand wash Water <br /> Slerno wlGhafFng <br /> Dish <br /> Paper Hand 1 owels <br /> Soap tlispenser <br /> Cueing Board Sanilizer bucket- <br /> bleach&water for <br /> PropanC SSOve <br /> Bleach staring wiping Goths <br /> Booth must be on <br /> Concrete,Asphalt, <br /> I Plywood,or a Tarp, <br /> Propane Tank <br /> ,E Soap and Welor Rinse Bleach atl water Garbage <br /> Can <br /> Fire Extinguisher <br /> Extra <br /> Water <br /> Ice Cooler 6 Gat Hand wash <br /> EKlra Ice Bags&Food Containers must be Wastewater Container <br /> Voted 6 inches off of the ground? <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/ehd <br /> EHD 16-02 Page B of 11 TEMP EVENT APP <br /> 07/01/2025 <br />