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SANl10AQUlN Environmental Health Department <br /> �?6�` ---COUNTY- <br /> aft,, <br /> i-rpnr��11 �r�wS ftrr•o <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 /> Mce chests [I Refrigerator <br /> ❑ Refrigerated truck Nke 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 /> ZKDetergent, bleach,and wiping cloths(cleaning towels) <br /> ub 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 /> KWater supply dispenser with warm water at a minimum of 100°F(i.e. 5-20 gallon container with spigot) <br /> NOne separate tub(bucket or basin)for the collection of rinse/wastewater. <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 /> Alondra Macias <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. Aalte� <br /> 2,'f <br /> 14. Completed by (� ha nw yl% /Signature Title <br /> 5-20 Gal <br /> Health Permit Ste Hand wash Water <br /> Sterna w/Cnatrmg <br /> D.sh paper Hand Towels <br /> Soap aapenser <br /> Cutting Board sanaver bucket- <br /> bleach S water for <br /> st0mv wV v Goths <br /> propane stove BI°aa' <br /> Booth must be on <br /> Concrete.Asphalt. <br /> Plywood. or a Tarp <br /> Propane Tank <br /> soap and Water Rinse Wxer Bleach and water Garbage <br /> Can <br /> F we E.jdvpwsher <br /> Erna <br /> Water <br /> FIceCoole 15 Get Hand Wash <br /> `( F,tra ka Begs 6 Food CoMamers must be wastewater Cordaarer <br /> - - stored 6 inches off of the granldr <br /> 1868 E Hazelton Avenue I Stockton, California 95205 T 209 468-3420 1 F 209 464-0138 1 www s}gov org/ehd <br /> EHD 16-02 Page 8 of 11 TEMP EVENT APP <br /> 08l2W2023 <br />