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R EC-008 <br /> SAN - 10AQUIN 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 OF temperature): <br /> ❑ Ice chests E;i 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 /> E;}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 /> U One separate tub(bucket or basin) for the collection of rinse/wastewater. <br /> [�j Paper towels and pump-style soar)container. <br /> 13. Names of responsible persons to be present in booth during all hours of operation: <br /> Aaryn 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 on inal to festival coordinator three weeks prior to <br /> this event. <br /> 14. Completed by: ( c f]7-06-202Fi <br /> vr��s <br /> , �torM1. y�y,.,rrrrzao,rwo — <br /> "i Title Date <br /> yr'rp1.1$.Lur c <br /> 5-20 Gal. <br /> Health Permit Hand wash Water <br /> 5larnc w,'Chalhng <br /> Dish <br /> Paper Hand Towels <br /> Soap dispenser <br /> Gulmtp Board Sanrlizer bucket- <br /> bleach 3 water for <br /> Propane$IO4e Blew, storing wiping daths <br /> po <br /> Booth must be on <br /> Concrete.Asphalt. <br /> Plywood.or a Tarp. <br /> Propane Tani <br /> Soap and water Rinse wafer Reach and Waler Garbage <br /> Can <br /> Fire Pdmp,rrsher <br /> Evlra <br /> weer <br /> FIceooler 5 Gal Hand wash <br /> EWa Ace Rags&Food Conlarers misf he Wastewater Container <br /> - - sforrtd 6 Arches ad of 11W ground.' <br /> 1868 E. Hazelion Avenue S Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/ehd <br /> EHP 16.02 Page 8 of 11 TEMP EVENT APP <br /> 06/1 W 19 <br />