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S A N J O A Q U 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 /> PK Ice chests X 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 /> X 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 /> X 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 /> Mishael Moran <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. <br /> 14. Completed by: Mishael Moran Owner 5/2/2024 <br /> Signature Title Date <br /> 5-20 Gal <br /> Health Permit Sterno w/Chaf Hand wash Water <br /> fing <br /> Dlsn Paoer Hand Towels <br /> Soao tlispenser <br /> Cutbnq Board Sarnbzer bock et- <br /> bleach&water for <br /> Propane Stove Bleach storing wiping cloths <br /> Booth must be on <br /> O Concrete,Asphalt. <br /> Plywood,or a Tarp. <br /> Propane 1anN <br /> --------------- <br /> Soap and Water Rmsn Water Bleach and Water Garbage <br /> Can <br /> Fire Exbngwsher <br /> Extra <br /> Water <br /> Ice Cooler will 5Gal Hand wash <br /> Extra Ice Bays&Food Containers must be Wastewater Container <br /> stored 6 inches off of the ground <br /> 1868 E Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br /> EHD 16-02 Page 8 of 11 TEMP EVENT APP <br /> 0713/17 <br />