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R EC-008 <br /> SAN J OAQ U I N Environmental Health Department <br /> COUNTY- <br /> 10. I 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 �Refrigerator <br /> ❑ Refrigerated truck ❑ Ice bath and tubs <br /> U Other(specify)Sandwich table &Freezer <br /> 11, 1 am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> [;J 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 /> [, Wafer supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br /> [;a 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 /> Shawndee Montero <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. -�-°w°° � I Owner/Operator 05-21-2026 <br /> 14, Completed by: <br /> uiy,�sn..sra-,exmsr<r .» Title Date <br /> era►us c <br /> 5-20 Gal. <br /> Health Permit Hard wash Water <br /> Sterna w.Chaffing <br /> Dish Paper Hard Toweis <br /> Soap dispenser <br /> Cutting Board Sanihzer buckeo- <br /> bleach a water for <br /> Prapana Slavo <br /> Bleach storing wiping doths <br /> Booth must be on <br /> Concrete,Asphalt, <br /> --- Plywood,or s Tarp. <br /> Prapane Tank <br /> Soap and Water Rinse Water [Meech and Waler Garbage <br /> Can <br /> Fro Fatinguisher <br /> EaUa <br /> water <br /> Ice Cooler 1 5 Gal Hand was h <br /> ,- Ex"ke,B3gs a Food Conraners nwsl be waslewater Container <br /> - ` scored 6 inches o7 of the ground& <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/ehd <br /> END 16-02 Page a of 11 TEMP EVENT APP <br /> O6,'1W19 <br />