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SA N : J QAQ U S 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 eF temperature): <br /> _21ce 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 /> —P�`hree deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br /> �soluti n(one tablespoon of bleach per gallon of water). <br /> �tergent, bleach,and wiping cloths(cleaning towels). <br /> b 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 /> 'Ellwater 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 /> Zrpaper towels and pump-style soap container. <br /> 13. Names of responsible pe s to be present in booth during all hours of operation: <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 /> arati a operation. Return original to festival coordinator three weeks prior to <br /> this v t. `,� r <br /> 14. Completed by: (y vV\-EQ' q -02C- <br /> Signature Title Date <br /> 5-20 Gal. <br /> Health Permit "and wash water <br /> Stern w/Chating <br /> Dish <br /> Paper Hand Towels <br /> Soap dslxnser <br /> Cutting Board Sanitizer bucket. <br /> bleach d water for <br /> Propane Stove Bleach <br /> slonn9 wiping cloths <br /> Booth must be on <br /> Concrete,Asphalt, <br /> f O Plywood,or a Tarp. <br /> Propane Tank - - <br /> Soap and Walw Rinbe Water Bleach and Water Garbage <br /> Can <br /> Fire Extinguisher <br /> Extra <br /> water <br /> Ice Cooler ! I .�Uw°"- � -". 5Gal Hand wash <br /> iErna Ice Bags d Food Conlahers must be Wastewater Container <br /> stored 6 inches off of the ground! <br /> 11 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/ehd <br /> EHD 16.02 Page 8 of 11 TEMP EVENT APP <br /> 06/29f2023 <br /> Scanned with CamScanner <br />