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A N v�J O A Q 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'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 /> OThree 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 /> '❑ etergent, 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 /> 0 One separate tub (bucket or basin)for the collection of rinse/wastewater. <br /> i <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 /> **Important** ` All food vendor booths 6ni 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 operation. Return original to festival coordinator three weeks prior to <br /> this eve <br /> 14. Completed by: r <br /> f Signature Title bate <br /> 5-20 Gel. <br /> Health Permit Hand wash water <br /> Sterno w/Chaffing <br /> Dish <br /> Paper Hand Towels <br /> Soap dispenser <br /> —\1 <br /> Cutting Board Sanitize'bucket- <br /> bleach&water for <br /> Propane Stove Bleach storing wiping cloths <br /> Booth must be on <br /> Concrete,Asphalt, <br /> 0; Plywood,or a Tarp. <br /> Propane Tank - <br /> Soap and Water Rinse Water Bleach and Water Garbage <br /> at <br /> Can <br /> Fire Extinguisher <br /> Extra <br /> Water <br /> Ice Cooler '`' / ` 5 Gal Hand wash <br /> Extra Ice Bags&Food Containers must be Wastewater Container <br /> stored 6lnches off of the ground! <br /> 1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1 www.s.igov.org/ehd <br /> EHD 16-02 Page 8 of 11 TEMP EVENT APP <br /> 06/19/19 <br />