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SANJOAQUIN Environmental Health Department <br /> COUNTY <br /> 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 Math 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 /> ®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 rinsemastewater. <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 /> Randy Harlan; Katie Harlan <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: organizer 11/26/25 <br /> Signature Title Date <br /> 5-20 Gal <br /> Health Permit Hard wash Water <br /> Sterrw wlChatYng <br /> nksh <br /> Paper Hand Towels <br /> Soap dispenser <br /> Cutting Board Sanitrzer bucket- <br /> bleach&water for <br /> storing wiping cloths <br /> Propane Stove Bleach <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> ------------- <br /> Propane Tank � ""�" _ — 3 <br /> Soap and Water Rinse Water 131each and Water Garbage <br /> Can <br /> Fire Extinguisher <br /> F�ctra <br /> Water <br /> 5Gal Hand wash <br /> Extra Ice Bags&Food Containers must be Wastewater Container <br /> stored 6 inches o!rolMe ground! <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 T 209 468-3420 F 209 464-0138 1 www.sjgov.org/ehd <br /> EH❑16-02 Page fi of 11 TEMP EVENT APP <br /> 06119/19 <br />