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S AWJ Q Q Q U I N Environmental Health Department <br /> 1NTY <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) <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 /> E; 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 /> `L�j Paper towels and pump-style soap container. <br /> 13. Names of responsible persons to be present in booth during all hours of operation: <br /> Elizabeth and Patrick Capito <br /> "*Important*" All food vendor booths are subject to inspection. Please make a copy of this application in <br /> preparation for t 6t. copy of this checklist must be in the booth at all hours of <br /> preparation an operettrrn original to festival coordinator three weeks prior to <br /> this event. 4/21/23 <br /> 14. Completed by: Owner <br /> %Signat r Title Date <br /> 5-20 Gal. <br /> Health Permit Hand wash Water <br /> Sterno w/Chaffing <br /> Dish <br /> Paper Hand Towels <br /> Soap dispenser <br /> Cutting BoardI —\1 Sanitizer bucket- <br /> bleach&water for <br /> Propane Stove Bleach <br /> storing wiping cloths <br /> Booth must be on <br /> 0 Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> Soap and Water Rinse Water Bleach and Water Garbage <br /> Can <br /> Fire Extinguisher <br /> EMra <br /> Ice <br /> Water <br /> Cooler <br /> 5 Gal Hand wash <br /> F,;t,,,,d <br /> Ice Bags B Food Containers must be Wastewater Container <br /> 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 />