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R EC-008 <br /> SAN QAQ Q N Environmental Health Department <br /> I_■■ �`.� COUNTY-- <br /> ..c_.F <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"F temperature): <br /> ❑ Ice chests [,�Refrigerator <br /> ❑ Refrigerated truck ❑ ice bath and tubs <br /> ❑ Other(specify) <br /> 11. I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> U 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 /> U 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 pump-style soap container. <br /> 13. Names of responsible persons to be present in booth during all hours of operation: <br /> Aaryn and Latisha Jones <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. •yam <br /> Owner 04-17-2026 <br /> 14. Completed by: — �— <br /> o 'OLUI c' '°'" "°"" Title Date <br /> : . <br /> 5-2D Gal. <br /> Health Pe Narrdwash Waler <br /> rmit <br /> Sler no wChalling <br /> b sh <br /> Paper Hand Towels <br /> Soap tlrspenser <br /> Cuthrw Buard sanrlizer bucAet- <br /> bleach&waler for <br /> Pn:pane 5tovr <br /> Bleach slonng vwping dalhs <br /> Booth must be on <br /> Concrete.Asphalt. <br /> Plywood,or a Tarp. <br /> Prgpane Tanh <br /> Soap and water Rinse Water Leach and Waler <br /> Garbage <br /> Can <br /> f-re E.Inra wsher <br /> Extra <br /> wal er <br /> �Ce (^jOQIQ� 5 Gal Hand wash <br /> Fera aco Bags&Food Conlaners musf to Wastewater Container <br /> -- stored 6+nches off or the ground.' <br /> 1868 E. Hazelion Avenue � Slockton, California 95205E T 209 468-3420 1 F 209 464-0138 1 www,sjgov.org/ehd <br /> EHD 16.02 Page S of 11 TEMP EVENT APP <br /> 06119119 <br />