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SA N 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��(if food is used the following day, maintain below 41°F temperature): <br /> L—,�, ce 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 /> so ition (one tablespoon of bleach per gallon of water). <br /> 0 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 rinse/wastewater. <br /> 2/Paper towels and pump-style soap container. <br /> 13. Names of responsible persons to be present in booth during all hours of operation: <br /> k,kt i Ck to+(A i A11t l V D i t 4 n V I an a, 16 V: Ci rA I,Cill g4 <br /> dloC S Me r uA <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 even <br /> 14. Completed by <br /> ignature Title Date <br /> 5-20 Gal. <br /> Health Permit <br /> Slemo wlChaffing Hand wash Water <br /> ash Paper Nand Towels <br /> Soao tlisAenaer <br /> Cutting Board Sanillzer bucket- <br /> bleach&water far <br /> alonng wiping cloth6 <br /> r'ropane Stove &each <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> Propane Tank <br /> Soap and Water Rinse Water Bleach and Water Garbage <br /> Can <br /> Fire E>ttinguisher <br /> Extra <br /> Wass t <br /> Ice Cooler 5Gal Hand wash <br /> Edna it Begs 6 Food Containers musf be Wastewater Container <br /> i stored 6 inches oR of the gro—df <br /> 1868 E Haze€ton Avenue 1 Stockton, California 95205 T 209 468-3420 1 F 209 464-0138 1 www.sjaov org!ehd <br /> EHU 16-02 Page B of 11 TFMP EVENT APP <br /> 06119f18 <br />