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I <br /> SANsJOAQUIN p <br /> � Environmental Health Department <br /> �;. .._._COUNTY-- <br /> n— <br /> Greatnes5 grows here. <br /> 10. I 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 /> x❑ 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 100eF(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 /> .lop anti Rprnarlpttp SnPnrpr <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 apd operation Return original to festival coordinator three weeks prior to <br /> this event. <br /> 14. Completed by: OwnerlOperator 7��I'Zaz`� <br /> Sig Title Date <br /> 5.20 Gal. <br /> Health Permit Hand wash Waler <br /> StCmO wlChaffinp <br /> 01sh <br /> Paper Hand Towels <br /> Soap dispenser <br /> Cutting Board Sanitlz"r buckel- <br /> hlearJlBwater for <br /> Propane Slava Bleach storing wiping cloths <br /> Booth must be on <br /> Concrete,Asphalt. <br /> ia, s Plywood,or a Tarp. <br /> Propane TankF Snap and Water Rinse Wet., Bleach and Water Garbage <br /> Can <br /> Fire Eximguishm <br /> Extra <br /> �ir t Sit;' Wa1ar <br /> 1 <br /> Ice Cooler „j 5 Gal Hand wesh <br /> Extra Ice Bags&Food Conte!ners must be Wastewater Container <br /> Stared 6 inches off of the ground! <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 J T 209 468-3420 J F 209 464-0138 J www.sjgov.orglehd <br /> EHD 16-02 Page 8 of 11 TEMP EVENT APP <br /> 06/19119 <br />