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ed <br /> /'0 SA Kd 0 A 0 U I N Environmental Health Department <br /> ` 6T� { 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 bath and tubs <br /> ❑Other(specify)nla for us <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 (l 5-20 gallon container with spigot). <br /> ❑■ One separate tub(bucket or basin)for the collection of rinse/wastewater. <br /> ❑M Paper towels and pump-style soap container. <br /> 13. Names of responsible persons to be present in booth during all hours of operation: <br /> Jayna Casey Bret Casey <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 /> thi vent. <br /> 14. Completed by: owner 11/7125 <br /> Sign re Title Date <br /> 5-20 Gal. <br /> Health Permit Hand wash Water <br /> Sterna wfChafring <br /> Dish <br /> Paper Hand Towels <br /> Soap tlispenser <br /> Cutting Board Sanitizer bucket- <br /> bleach&water for <br /> Propane Stove <br /> Bleach storing wiping cloths <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> Propane Tank - '�^"'�""^^'"""'^ —— <br /> Soap and Water Rinse a[er Bleach and water Garbage <br /> Can <br /> Free Eztinguisher <br /> r 6ctra <br /> Water <br /> Ice Cooler 5Gal Hand wash <br /> Extra Ice Bags&Food Containers mast be Wastewater Container <br /> stored 6 inches off of the gmundl <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 T 209 468-3420 F 209 464-0138 1 www.sjgov.org/ehd <br /> EHD 1M2 Page 8 of 11 TEMP EVENT APP <br /> 06119/19 <br />