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S A N J O A Q U I N Environmental Health Department <br /> - CUUi,i Y <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 OF temperature): <br /> ❑ Ice chests ® Refrigerator <br /> ❑ Refrigerated truck ❑ Ice bath and tubs <br /> ❑ Other(specify) on board freezer <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 dnselwastewater. <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 /> Randy Harlan. Katie Harlan <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. r, <br /> 14. Completed by: coordinator ;�� 2023 <br /> Signature Title date <br /> 5-20 Gal. <br /> Health Permit Hand wash Water <br /> Steme wlChaRng <br /> Dish <br /> Paper Hand Towels <br /> Soap dispenser <br /> Cutting Board Seni6xer buckel- <br /> bleach 8 water for <br /> Propane Stove Bleach storing wiping cloths <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> Propane TankVF <br /> Soap and Water Rinse Water Bleach and Water Garbage <br /> Can <br /> "re Extinguisher <br /> F�ctra <br /> water <br /> Ice Cooler / 5 Gal Hand wash <br /> Ezfre Ice Bags 6 Food Containers must be Wastewater Container <br /> stored 6 kwtws all of ft ground! <br /> 1868 E. Hazelton Avenue 1 Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 I www.sjgov.org/ehd <br /> EHD 16-02 Page S of 11 TEMP EVENT APP <br /> 06/19119 <br />