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N 0 A 0 U I N Environmental Health Department <br /> COUNTY <br /> 10. I 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 /> ❑ 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 /> Matab Singh <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 op ration. Retum original to festival coordinator three weeks prior to <br /> t <br /> 14. Completed by: this even e3,,7�L ,��,� r '"Z�Z/ <br /> Signature Title Date <br /> I <br /> 5-20 Gal. <br /> Health Permit Hand wash Water <br /> Sterne wlChatfing <br /> Dish <br /> Paper Hand Towels <br /> SoaU 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 /> Plywood,or a Tarp. <br /> Propane Teak <br /> Soap and Watar Rinse Water Bleach and Water Garbage <br /> ' Can <br /> Fire Exinpuisher <br /> EXira <br /> ICe COf�ler w 5 Gal Hand wash <br /> Fxtra fce Bags&Food Contakws must be Wastewater Container <br /> scored i arches off of the groundr <br /> 1868 E. Hazelton Avenue ( Stockton, California 95205 T 209 468-3420 F 209 464-0138 1 www.sjgov.org/ehd <br /> EHD 16-02 Page 8 of 11 TEMP EVENT APP <br /> 06129/2023 <br />