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R EC-008 <br /> S A N 10 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 /> 45OF(if food is used the following day, maintain below 41'IF temperature): <br /> Ice chests ❑ Refrigerator <br /> ❑ Refrigerated truck ❑ Ice bath 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 rinse/wastewater, <br /> Paper towels and Rump-style soap container. <br /> 13. Names of responsible persons to be present in booth during all hours of operation: <br /> Faith previterla <br /> Samantha Nolasco <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 /> Owner 04-21-2025 <br /> 14. Completed by: �am�.rr�r�fJ'tcc�zaee <br /> •.,M,x,.<wpa a,-0,��x, Title Date <br /> aiyt taws c <br /> 5-20 Gal. <br /> Health Permit Hand wash Water <br /> Sterna w'Chalkng <br /> Dish <br /> Paper Hand Towels <br /> Soap dispenser <br /> CUII np epatd Sanitirer bucket- <br /> bleach E water lot <br /> Propane Sta,<e <br /> Bleach slorhng Wiping doths <br /> Booth must be on <br /> Concrete,Asphalt, <br /> - Plywood.or a Tarp. <br /> Propane Tank <br /> Soap and Water Rinse Water i;•:. <br /> &each arid Waler Garbage <br /> Can Fre Exhnpuisher <br /> ExUa <br /> Water <br /> Ice Cooler ` S Gal Hand wash <br /> Extra ka Bags 8 Foul Conlarhers must ba Wastewater Container <br /> stored 6 ruches off or the ground! <br /> 1868 E. Hazelton Avenue 1 Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/ehd <br /> EHD 16-02 Page 8 of 11 TEMP EVENT APP <br /> p6'19119 <br />