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R EC-008 <br /> ;- $ANC OAQUIN Environmental Health Department <br /> lam- K" c- 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 /> U 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 /> U 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 100OF (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 pump-style soap container. <br /> 13. Names of responsible persons to be present in booth dudng all hours of operation: <br /> Trevor Odom <br /> Aidan Larson <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 10 festival coordinator three weeks prior to <br /> this event. <br /> 4 P�oS� r�dd Owner 04-08-2026 <br /> 14. Completed by: <br /> r71^y l ld ll'C"" :c'somo1i0 Title date <br /> 5-20 Gal <br /> Health Permit Hand washWaler <br /> Slarno w ChalGng <br /> Dish <br /> Paper Hand Towels <br /> Soap dispenser <br /> Culling Board sanilizer dackriv <br /> bleach&waler for <br /> Propane Stove <br /> pleaeh stonng wring dalhs <br /> U bu 0 [,Z, FP1'yW11d. <br /> MUron <br /> onCrete,Aspha or a Tarp. <br /> Propane Tank <br /> Soap and Walar Rinse Water Bleach and Water Garbage <br /> ` Can <br /> Fa a E.lmpwsher <br /> Eaha <br /> W.ycr <br /> Ii <br /> Ice CooEer J 5Ga!Hand wash <br /> Fats keBags 8 FoodComauiers moslbe Waslewaler Ccntarnar <br /> s!ored 6 iodies oN of Me provrrd' -------------- <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 T 209 468-3420 1 F 209 464-0138 www.sjgay.orgrehd <br /> EHD I6-02 Page B of 11 TEMP EVENT APP <br /> 06!19!19 <br />