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ocusign Envelope ID:44C40311D-2BBA-4459-9.97' ')DCD7209A1B <br /> J <br /> S A N J OA Q U I N Environmental Health Department <br /> COUN I Y <br /> Greatness grows her( <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 /> ® 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 /> Carleton Edwards, Sheryl Edwards, Jackie Thomas. Rayven Mann <br /> "Important" All food vendor booths are subject to inspection. Please make a copy of this application in <br /> preparation for this event. copy of this checklist must be in the booth at all hours of <br /> preparation and operatio . Return original to festival coordinator three weeks prior to <br /> this event. <br /> 14. Completed by: �/ <br /> Signature Title at <br /> 5-20 Gal. <br /> Health Per Hand wash Water <br /> Stemg w;Chaffmg <br /> Dist- Paper Hanc Towels <br /> SgaC dispenser <br /> Cuthng Boarc Sarrtrzer bucket- <br /> bleach&water for <br /> Propane Stove <br /> 31eart storing wiping cloths <br /> Booth must be on <br /> O Concrete.Asphalt. <br /> Plywood.or a Tarp. <br /> Propane Tank <br /> Soap and Water Rinse Aa.cr Bleach and Water Garbage <br /> Can <br /> Fire Exhrqui her <br /> Extra <br /> Aa;er <br /> Ice Cooler 5 Gal Hand wash <br /> Extra Ice Bags&Food Confame,s must be Nastewater Container <br /> - stored 6 inches off of the ground <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 T 209 468-3420 F 209 464-0138 1 www.sjgov.org/ehd <br /> EHD 16-02 Page 8 of 11 TEMP EVENT APP <br /> 06/19119 <br />