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S A N J O A Q U I N Environmental Health Department <br /> COUNTY <br /> Greatness grows here. <br /> 10. t 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 /> [Z 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 rinselwastewater. <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 /> k1ur- rCA(-c" MeiLiu S <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. y� ^ <br /> 14. Completed by: <br /> Signature Title Date <br /> 5-20 Gal. <br /> Health Permit Hand wash Water <br /> Slernu wlChaHing <br /> Dish <br /> Paper Hand Towels <br /> Soap dispenser <br /> Cutlinq board Sanitizer buckel- <br /> blaaeh B water for <br /> Propanu Stove Blearh storing w�pmg doths <br /> 1\ 41 <br /> Booth must be on <br /> O Concrete,Asphalt. <br /> Plywood,or a Tarp. <br /> _.X, <br /> Propane Tanh <br /> ------------- <br /> Soap anti Waler Rinse Water 61earh and Water Ci8rb8LJe <br /> Can <br /> Fire Ex$nguisher <br /> E Ktr, <br /> Water <br /> Ice Cooler 5 Gal Hand wash <br /> Extra Ice Bags 6 Food Confainera mus!ba Waslewaler Container <br /> strived 6 inches off of the groenri? <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 T 209 468-3420 F 209 464-0138 1 www.sjgov.org/ehd <br /> EHD 16-02 Page S of 11 TEMP EVENT APP <br /> 0612 9/2 0 2 3 <br />