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51CAJEnvironmental Health Departryient <br /> L4 ' COUNTY <br /> Greatness grows here. <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 419F temperature): <br /> ❑I■ 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 /> ❑r 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 persons to be present in booth during all hours of operation: <br /> Dan Van Gorningen <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 99three weeks prior to <br /> thf L]nalw[14. Ccmpleted by: fn re Tit Date <br /> 5-20 Gat. <br /> ater <br /> Hc.3kh Pr-,rmit Hand wash w <br /> Sterno w1ChalFing <br /> Otsh <br /> ftpCr Hand l swats <br /> svaP dispenser <br /> Cuhing Boaa i1 $enitizer buckel- <br /> h[each S avatar Fvr <br /> Propane Salve Bleach storing vAping cloths <br /> Booth must be on <br /> Concrete,Asphalt. <br /> Plywood,or a Tarp. <br /> PrapaneTenk <br /> Soap and avatar Pill.ntar Bleach and Water Garbage <br /> Can <br /> Fire Fxtngutr}er <br /> � <br /> Aq <br /> Ice Cooler s Gal Hand wash <br /> Exna i�fiagg e Fcwd Con,alners rrwst be WaslewaLx Conta ner <br /> sMrvA 6,nanrc ol7af ton grnund! <br /> 1868 E. hlazelton Avenue I Stockton,California 95205 T 209 468-3420 I F 209 464-0138 1 www.sjgov,orglehd <br /> END 16-02 Page a crf 11 TEMP EVENT APP <br /> OE119119 <br />