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SAN J OAQ U I N Environmental Health Department <br /> 10. 1 am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 45eF(if food is used the following day, maintain below 41eF 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 incites 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 100eF(Le, 5-20 gallon container with spigot). <br /> V <br /> One separate tub (bucket or basin)for the collection of rinsetwastewater. <br /> Paper towels and pump-style soap container. <br /> 13, Names of responsible persons to be prese t in booth duri,pg all hours of operation: <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 evert . , <br /> 14. Completed by: <br /> Signature Title Date <br /> ,. . <br /> 5.20 GaL <br /> Health Permit ' Hand wash Water <br /> Sterno wlChafTinq <br /> Posh paper Nand rowos <br /> Soap of spensar <br /> Culanp Bo W SaMllier bucket- <br /> bleach Q waler to7 <br /> Propane Stove Filend, slonnq wti cloths <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp, <br /> l•mpane rant <br /> Saep and Wata Pinaa Water Bleach and Water Garbage <br /> Can <br /> Fro CxlUrqulshar <br /> Ea1ra <br /> Water <br /> fee Cooler 5 Gal Hand wash <br /> i - Eitra Ice Sags d Food Containers must be ft Wastewater Container <br /> stored 6 inches oMorthe gtoi y <br /> 1868 E. I lazelton Avenue I Stockton. California 95205 1 T 209 468-3420 1 F 2.09 464.0138 1 www.sjcehd.ccm <br /> [HD 16-02 Page 8 of 11 TEMP EVENT APP <br /> 0713117 <br />