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S A N J O A Q U I N Environmental Health Department <br /> COUNTY <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 /> ❑ Refrigerated truck ❑ Ice bath and tubs <br /> ® Other(specify) mobile freezer unit <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 /> L ❑ 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 /> Joey Vigil!Andrew Alexander <br /> "Important" All food vendor booths are subject to inspection. Please make a copy of this application in <br /> preparation for this eve . A copy of this checklist must be in the booth at all hours of <br /> preparation Ad operatigh. Return original to festival coordinator three weeks prior to <br /> this event <br /> 14. Completed by: NM { <br /> ature Title IDa e <br /> 5-20 Gal. <br /> Health Permit Hand wash water <br /> Sterna wlChafring <br /> Dish Paper Hand Towels <br /> Soap dispenser <br /> Cutting eoald Sanitizer buckel- <br /> bleach a water for <br /> storing wiping cloths <br /> E�] <br /> Bleach <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> Propane Tank <br /> ------------ <br /> Soap and Water Rinse Water Bleach and Water Garbage <br /> Can <br /> Fire Extinguisher <br /> it <br /> Extra <br /> Wa[er <br /> �+ <br /> r <br /> Ice Cooler 5 Gal Hand wash <br /> Extra Ice Begs 6 Food Containers must be Wastewater Container <br /> srorad 6 Inches art of the ground! <br /> 1 <br /> 1868 E. Hazelton Avenue l Stockton, Califomia 95205 l T 209 468-3420 1 F 209 464-0138 l www.sjgov.org/ehd <br /> EHD 16.02 Page 8 of 11 TEMP EVENT APP <br /> 06/19119 <br />