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SAN J O A Q 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 /> 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 rinsetwastewater. <br /> Paper towels and pump-style soap container. <br /> 13. Names of responsible pe(r ons to be r in b th during all hours of operation: <br /> CC <br /> IF <br /> "*Important" Ali 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. Re ori inal to festival coordinator three weeks prior to <br /> this event. �l <br /> 14. Completed by: <br /> Signature Title Date <br /> 5-20 Gat <br /> Health Permit Hand wash Water <br /> Slprno w,Chaffenp <br /> Dish <br /> Paper Hand Towels <br /> Soap dispenser <br /> Cullnq Roard Samtizer bucket <br /> bleach S waferlor <br /> Propane Stpve Bleach storn-q wiping cloths <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Plywood,or a Tale. <br /> propane rank <br /> Soap and Water Rmse Waler Bleach and Water Garbage <br /> Can <br /> Fire Extinguisher <br /> Extra <br /> Wafer <br /> Ice Cooler '�;. u;rtwl;:,azs:• rr•; •spff.� 5GetHand wash <br /> EWa Ice Baps d Food Containers must be Wastawaler Container <br /> stored d inches c11 olthe graundr <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.corn <br /> FHD 16-02 Pagu 8 or 11 TEMP EVENT APP <br /> 0713,17 <br />