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SA N J OAQ U I N Environmental Health Department <br /> COUNTY <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 /> 0'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 /> O'Yub 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 um -s ale soap container. <br /> 13. Dames 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 on inal to festival coordinator three weeks prior to <br /> this event. <br /> 14. Completed by: f A.ne ✓ i� i-4 <br /> gnat re Title pate <br /> 5-20 Gal. <br /> Health Permit Hand wash Water <br /> Stemo w/Chaffing <br /> Dish Paper Hand Towels <br /> Soap dispenser <br /> Cutting Board Sa""Zer bucket- <br /> bleag 8 water far <br /> Propane Stove <br /> Bleach storing wiping cloths <br /> ol <br /> Booth must be on <br /> Concrete,Asphalt, <br /> r Plywood,or a Tarp. <br /> Soap and Water Rinso Water Bleach and Water Garbage <br /> Can <br /> Fire Extinguisher <br /> Extra <br /> Watar <br /> Ice Cooler 5 Gal Hand wash <br /> Extra ke Begs B Food Containers must be Wastewater Container <br /> stored 6 inches o!t of the ground! <br /> 1868 E- Hazelton Avenue I Stockton, California 95205 T 209 468-3420 F 209 464-0138 1 www.sjcehd.com <br /> EHD 16-02 Page 8 of 11 TEMP EVENT APP <br /> 0713M 7 <br />