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SAN J O A Q U I N 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 /> 45°F(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. 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 /> ❑ (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 /> ❑ 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 /> Dinah Washington <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. 4/14/26 <br /> 14. Completed by: Dinah Washington Owner <br /> Signature Title Date <br /> t.,,,_A.y-.. -.-,.°':a-•:�7 5-20 Cel. <br /> HealthPermitHand wash Water <br /> Sterno wlCltef6ng <br /> 131911 Paper Hand Towels <br /> Soap dispenser <br /> Culling Board Santlizer bucket- <br /> hleach&water for <br /> Propane Stove <br /> Bleach staring vAping c;aths <br /> Booth must be on <br /> O Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> PrapaaeTank <br /> /I <br /> scan and water Rinse Wetor Bleach and Water Garbage <br /> Can <br /> Fire Extinguisher <br /> Extra <br /> wafer <br /> Ice Cooler - <br /> Itip -- _ ;: 5Gal HandWash <br /> Extra Ice Bags 8 Food Contefners must be Wnstowater Container <br /> shred 6 inches off of tho ground! <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 j T 209 468-3420 j F 209 464-0138 j www.sjgov.org/ehd <br /> FHD 16-02 Page 8 of 11 TEMP EVENT APP <br /> 07101/2025 <br />