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S A N J OA 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 /> ❑ 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 /> KI 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 /> CEGI!erji7 Cys 41 [,L.A <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 op <br /> erati n. Return original to festival coordinator three weeks prior to <br /> this ev It. <br /> 14. Completed by: t` l)�� I� J 7_� 7 <br /> Signature Title Date <br /> 5-20 Gal. <br /> Health Perrrtit SEe Hand wash Water <br /> mo wlChaffmg <br /> plsh <br /> Paper Hand Towels <br /> Soandlspenser <br /> Cutting board Sanitize'bucket- <br /> bleach$water for <br /> Propane titove Bleach stodng wiping cloths <br /> Booth must be an <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> Propane Tank <br /> Soap and Water Rinse Water Bleach and Water Garbage <br /> Can <br /> Fire Exinguisher <br /> CMra <br /> Water <br /> i, r1ce Cooler - - 6 Gal Hand wash <br /> t Eufra Ice Bags 6 Food Cantamers must be Wastewater Container <br /> stored 6 inches aBaf the ground! <br /> 1868 E. Hazelton Avenue E 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 /> 06129/2023 <br />