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SAN.-,,IOAQUIN Environmental Health Department <br /> COUNTY <br /> Cr�cll,i ri fiorr. <br /> 10, 1 am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 45aF (if food is used the following day, maintain below 41°F temperature): <br /> Ek Ice chests URefrigerator <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 /> "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: <br /> Signature Title Date <br /> 5-20 Gal. <br /> Health Permit111 Hand wash Water <br /> StemwIChaffing <br /> Dish <br /> Paper Hand Towels <br /> Soap dispenser <br /> Cutting Board Sarlitlzer bucket- <br /> bleach&water for <br /> Propane Stove Bleach stodng wiping Goths <br /> Booth must be on <br /> Concrete.Asphalt, <br /> O Plywood,or a Tarp. <br /> Prapana7ank - - <br /> Soap and Water Rinse Water aleach and Water Garbage <br /> Can <br /> Fire E7dingulsher <br /> Extra <br /> water <br /> Ice Cooler 5 Gal Hand wash <br /> Extra Ice Begs&Food Centamers most he Wastewater Conlainer <br /> stored 6 inches off of the grounds <br /> 1868 E. Hazelton Avenue I Stockton, California 952051 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 /> 06119/19 <br />