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e 9 SAN.J0AQUIN Environmental Health Department <br /> COUNTY---.. <br /> Greatness grows iI r <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 /> ZIce 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 /> tOne separate tub (bucket or basin)for the collection of rinse/wastewater. <br /> \ <br /> ''Paper towels and pump-style soap container. <br /> 13. Names oresponsible persons to be present in booth during all hours of operation: <br /> _11InLir-lA %1 Ai l rya c <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. (,� M <br /> 14. Completed by: a LimAe t:& 0LA.)A?,r qua <br /> Signature Title Date <br /> ®® 5-20 Gal. <br /> Health Permit Hand wash Water <br /> Stemo w/Chaffing <br /> Dish N <br /> Paper Hand Towels <br /> Soap dispenser ' <br /> Cutting Boa rcf 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 Tank <br /> Soap and Water Rinse Water Bleach and Water <br /> agd Garbage <br /> jy Fire Extingufaher Can <br /> 114k�)MO <br /> «, Wacer <br /> �Ce Cooler 5 Gal Hand wash <br /> Extra!ce Bags 8 Food Conterners must bo Wastewater Container <br /> arored 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 www.sjgay.org/ehd <br /> EHD 18-02 Page 8.of 11 TEMP EVENT APp <br />