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SKJ O Q Q U I N Environmental Health Department <br /> —COUNTY— <br /> Greatness groins here. <br /> 10. l am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 45OF(if food is used the following day, maintain below 41°F temperature): <br /> Klee 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 /> Three deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br /> ution(one tablespoon of bleach per gallon of weber). <br /> Detergent,bleach,and wiping Goths(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 /> One separate tub(bucket or basin)for the collection of rinseMrastewater. <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 /> "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 tooth at all hours of <br /> preparation and operation. Return original to festival coordinator three weeks prior to <br /> this event <br /> 14. Completed by: M fir5 <br /> Signature Title Date <br /> &20 GaL <br /> Health Permit Hand <br /> '�h"'e� <br /> stems wlChafrrg <br /> Dist, <br /> Paper Hand Towels <br /> Soap dispenser <br /> GIZ�InA 808fd sanft¢er t]udCal- <br /> Meadt&Water for <br /> st0.t wk*V daths <br /> Propane Stove eksath <br /> Booth[rust be on <br /> Conmte,Asphalt, <br /> Plywood,or a Tarp. <br /> Propane Tank - -- <br /> i Soap end Water Rinse Water ekwh mid water Garbage <br /> Can <br /> ! 6mra <br /> f . <br /> water <br /> Ice Cooler - 6Gal Haw wash <br /> Extra ke Bays 6 Food ConhWw s must U. Wastewater Cmtakw <br /> stared 5 EnrNss Oa/rhegrwndt <br /> 1868 E_ Hazelton Avenue 1 Stockton, California 95205 T 209 468-34201 F 209 464-0133 1 www.sjgov.org/ehd <br /> EMD 1"2 Pages of 11 TEMP EVENT APP <br /> =19119 <br />