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S N JOAOUIN 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)N/a for us <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 /> ®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 /> ® Paper towels and pump-style soap container. <br /> 13. Names of responsible persons to be present in booth during all hours of operation: <br /> Jayna Casey, Bret Casey <br /> **Important** <br /> 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 /> 14. Completed by: this Owner 4/15/24 <br /> ig a ure Title Date <br /> 5-20 Gal, <br /> Health Permit Hand wash Water <br /> Stemo w/Chaff ng <br /> Dish <br /> Paper Hand Towels <br /> Soap dispenser <br /> Cutting Board Sanitizer bucket- <br /> bleach&water for <br /> Propane Stove Bleach storing wiping cloths <br /> Booth must be on <br /> Concrete,Asphalt, <br /> O' Plywood,or a Tarp. <br /> Prcpane Tank ,,..... <br /> ------------- <br /> Soap and Water Rinse WaLa <br /> Water Garbage <br /> Can <br /> Fire Extinquisher <br /> ice Cooler _"'`'' ' <br /> Extra Ice Bags&Food Containers must be i Wastewater Container <br /> '` ---- -- --- stored 6 inches off of the ground! ' <br /> 1868 F. 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 /> 06/19/19 <br />