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s <br /> r 5 <br /> C,." <br /> s <br /> SAN JOAQUIN Environmental Health Department <br /> i ti , , = Y <br /> 10. 1 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 OF temperature): <br /> chests [Refrigerator <br /> F 1�efrigerated truck ❑Ice bath and tubs <br /> ❑Other(specify) <br /> 11. 1 am pr viding the following items within my booth for the sanitary cleaning of food preparation utensil <br /> ree compartment sink. <br /> OR <br /> .t ,ee 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 /> ater supply dispenser with warm water at a minimum of 100eF(i.e. 5-20 gallon container with spigot). <br /> ne separate tub(bucket or basin)for the collection of rinselwastewater. <br /> aKa-p'er towels and pump-style soap container. <br /> 13. Names of responsible persons to be pre en 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 booth at all hours of <br /> preparation and operation. R urn original to festival coordinator three weeks nrinr+n <br /> this ev �J <br /> 14. Completed by: aGc/.c � �pC <br /> Sig Title Date <br /> f, w,>T' 41p�°"��f�Y'4S'1•'S 5.20 Gat, <br /> Health Permit Hand wash Water <br /> Stemo w/Chaffing <br /> Dish Paper Hand Towels <br /> Soap dsDensar <br /> Cutting Board sanilizef buckol. <br /> bteach a water for <br /> Propane Stowe Bleach atonng wipVnq cloths <br /> Booth must be on <br /> Concrete.Asphalt, <br /> Plywood,or a tarp. <br /> Propane Tenk <br /> Soap and Water Rinse Wafer Bleach and Water Garbage <br /> Can <br /> Fife Ekling"her <br /> Extra <br /> Water <br /> rice Cooler— 5 Gil Hand wash <br /> I Extra fee Bags d Food Containers must be Wastewater Container <br /> stored 4 inches off or the graundr ' <br /> 1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.orglehd <br /> CHD 1&02 Page Be 11 TEMP EVENT APP <br /> O6I19119 <br />