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SAN 10AQUIN Environmental Health Department <br /> f = COU N'"Y" <br /> Grecrt"o<.r er'n*b h'rt <br /> 10. 1 am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 45e17(if food is used the following day,,naintain 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 respon rrsogs too bepresent 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 t1this event. A copy of this checklist must be in the booth at all hours of <br /> preparation J6d operation. Return original to festival coordinator three weeks prior to <br /> this ev <br /> 14. Completed by: -t !iJ'v L' �•v/,f" rT <br /> --� igriature 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 Board Sanitizer bucket- <br /> bleach&water for <br /> Propane Stove Bleach 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 Water Bleach and Water Garbage <br /> Can <br /> Fire Extinquisher <br /> Extra <br /> Water <br /> Ice Cooler i ^` 5 Gat Hand wash <br /> Extra Ice Bays&Food Confafners must be Wastewater 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 /> 07/01/2024 <br />