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R EC-008 <br /> SAN ,,JOAQUIN 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 OF temperature): <br /> Ice chests [;J Refrigerator <br /> ❑ Refrigerated truck ❑ Ice bath and tubs <br /> Other(specify)Sandwich Prep Refigeration <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 (Le. 5-20 gallon container with spigot). <br /> 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 /> David Patterson <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. pwner 04-13-2026 <br /> 14. Completed by: <br /> Title Date <br /> 5-20 Gal. <br /> Health Per Il Hand wash Water <br /> Sler rw w'Chal brig <br /> Dish Paper Hand Towels <br /> Suup Usiensur <br /> Cul�nq Board Sandrzer bucket- <br /> bleach 8 water for <br /> Pruprmre Slne Bleach storury upping cloths <br /> EP', <br /> h must be on <br /> O rete.Asphalt. <br /> od,or a Tarp. <br /> Propane Tana <br /> Soap and Water Rinse Waler Bleach and Waler Garbage <br /> Can <br /> Fre Exti npwsher <br /> EIr3 <br /> Water <br /> Fcejoole[ D 5Gal Hand wash <br /> Extra ke Sags&Food Conlaners nerst be Wastewater Container <br /> stared 6 Inches off or rite grwnd' <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 F 209 464-0138 1 www.sjgov.orgt`ehd <br /> EHD t6 02 Page B at I I TEMP EVENT APP <br /> 0,5 19 19 <br />