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AN-JOAOUIN Environmental Health Department <br /> ---COUNTY �--- <br /> f{ F GreatAes5 arovrs 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 OF temperature): <br /> ❑ Ice chests ❑ Refrigerator <br /> ❑ Refrigerated truck ❑ Ice bath and tubs <br /> Other(specify) a) -t r Get 1"GY�� <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 " 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.a, 5-20 gallon container with spigot). <br /> ❑ One separate tub(bucket or basin)for the collection of rinselwastewater. <br /> [] Paper towels and pump-style soap container. <br /> 13, Nam of responsible persons to present in booth during all hours of operation: <br /> [UX i <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 ori_ final to festival coordinator three weeks prior to <br /> this event. <br /> 14, Completed by: Atr <br /> Signature Title Date <br /> 6-20 Gal. <br /> Health Permit Hand wash Water <br /> Stem wiChaffing <br /> Dish <br /> Paper Hand Towels <br /> Soap dlSpen4er <br /> Cutting Baard Sanitizes 11fl- <br /> bleach 8 water fa <br /> Propane Store Bleach storing wiping Cloths <br /> F <br /> must the on <br /> te,Asphalt, <br /> d, or a Tarp. <br /> Propane Tanis -- r - <br /> Soap and Water Rlrise Water Bleach and Water Garbage <br /> her Can <br /> Fire Extinguis <br /> Extra <br /> Water <br /> rt <br /> Ice Cooler 5GalHaldwash <br /> Extra Ice Sags&Food Containers mast be Wastewater Container <br /> stored&inehes oft of the ground! <br /> 1868 E. Hazelton Avenue Stockton, California 95205 T 209 468-3420 F 209 464-0138 1 www.sjgov.org/ehd <br /> EHD 16-02 Page 9 of 11 TEMP EVENT APP <br /> 06/19119 <br />