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SAN JOAQUIN Environmental Health Department <br /> -COUNTY----- <br /> i <br /> 10. 1 am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 45°F (if food is used the following day, maintain below 41 eF 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 /> El Detergent, bleach, and wiping cloths (cleaning towels). <br /> El 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 /> El 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 /> L] Paper towels and pump-style soap container. <br /> 13. Namesof responsible persons to be present in booth during all hours of operation: <br /> _ <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 /> 14. Completed by: <br /> ignature Title Date <br /> 5-20 Gal. <br /> Health Permit Hand wash Water <br /> Sterno w1ChaNing <br /> Dish <br /> Nagar}land Towels <br /> Soap dispenser <br /> Cuttuyl Dvard Sanih7er bucket- <br /> bleach&water(or <br /> Piopana Stove <br /> Bleach storing wiping cloths <br /> Booth must be on <br /> O Concrele,Asphalt, <br /> Plywood,or a Tarp. <br /> Propane Tank <br /> Soap and Water Rinse Water Bleach and Water Garbage <br /> Can <br /> Fire Extindu-sher <br /> Extra <br /> Water <br /> Ice Cooler 5Gal Hand wash <br /> Fxtra Ice 13a93&Food Containers rnesl he Wastewater Container <br /> stored 5 Inches off 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 /> EHD 1"2 Page 0 of 11 TEMP EVENT APP <br /> 07/0112025 <br />