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r <br /> Environmental Health Department JOAQUIN partment <br /> t+ kl_i' COUNTY <br /> U1•E'otneSs (�r{?w5 �!^r'F <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 /> W 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 /> 0 Paper towels and pump-style soap container. <br /> 13. Names of responsible persons to be present in booth during all hours of operation: <br /> John Wall or Frank Teixeira <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: John Wall Member 4-15-24 <br /> Signature Title Date <br /> - 5-20 Gal <br /> Health=PermitHealth Permit Hand wash Water <br /> Sterna wlChaffing <br /> Cish <br /> Paper Hand Towels <br /> Soap tlispenser <br /> Cutting Board Sanitizar buaket- <br /> bleach&water for <br /> Propane Stove Bleach storing wiping Goths <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> Propane TankAF� - <br /> Saapand Water Rinse ater bleach and Water Garbage <br /> Can <br /> Fire EAngulsher <br /> Extra <br /> Water <br /> Ice Cooler 5 Gal Hand wash <br /> Extra roe Rags&Food Containers musl be Wastewater Gortainer <br /> stared 6 inches offorlhe 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 /> EH❑16-02 Page a of 11 TEMP EVENT APP <br /> 06/19/19 <br />