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el) <br /> IL <br /> SA N-tJ 0 A 0 u(N Environmental Health Department <br /> COUNTY <br /> [�,1tfr 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 /> X 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 /> ❑■ 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 /> adriana Villanueva <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 oft s checklist must be in the booth at all hours of <br /> preparation anoperation.,4Retum original to festival coordinator three weeks prior to <br /> t rtt. <br /> 14. Completed by: JOwner/Cook 11/17/2025 <br /> nat a Title Date <br /> 5-20 Gal. <br /> Health Permit Hand wash Water <br /> Sterno wlchaff ng <br /> ❑ish <br /> Paper Hand Towels <br /> Soap dispenser <br /> Cutting board Sanifter bucket- <br /> bleach&water for <br /> Propene Stove <br /> Bleach storing wiping cloths <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> Propane Tank \4 <br /> Soap antl Water Rinseater Bleach and Water Garbage <br /> Can <br /> Fire Extinguisher <br /> Extra <br /> Water <br /> Ice Cooler 5Got Hand wash <br /> Extra Ice Sags 8 Food Containers must he Wastewater Container <br /> stored 6 inches off of the ground? <br /> 1868 E. Hazelton Avenue E Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/ehd <br /> EHC 16-02 Page 6 of 11 TEMP EVENT APP <br /> 06119119 <br />