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i <br /> iSAN J O A Q U I N Environmental Health Department <br /> COUNTY <br /> f Greatrlesi grows hertz. <br /> 10. 1 am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 450F (if food is used the following day, maintain below 41°F temperature): <br /> ❑ Ice chests ❑ Refrigerator <br /> t <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 utens <br /> OR <br /> Three compartment sink. � ���, ` <br /> _ �� t � ()forGThree deep tubs (basins 6-8 inches minimum), one for soapy water, rinsing and one or 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. (b <br /> ��� j 0 <br /> 13, Names of responsible persons to be present in booth during all hours of operation: FM Uf VE"(007 <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. tY00- <br /> 14. IN ■� � <br /> Completed by: Z_-, ` <br /> SkIliarure Title D to <br /> 5-20 Gal. <br /> Health Permit Hand wash Water <br /> $t8fn0 w1ChaNing <br /> Dish <br /> Paper Hand Towels <br /> Soap dispenser <br /> cutting Board Sanitizer buckel- <br /> bleach&water for <br /> Propane Stave <br /> Bleach storing wiping cloths <br /> Booth must be on <br /> Concrete.Asphalt, <br /> r!!p Plywood,or a Tarp. <br /> Propane <br /> Soap and Water Rinse Water Bleach and Water Garbage <br /> Can <br /> — Fire Extinguisher <br /> Extra <br /> Water <br /> Ice Cooler 5 Gal Hand wash <br /> Extra tee Bags&Food Containers must be Wastewater Container <br /> stored 6 inches oNot the ground! JI — <br /> 1868 E. Hazelton Avenue 1 Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/ehd <br /> EHD 16-02 Page 8 of 11 TEMP EVENT APP <br /> 07/01/2025 <br />