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SAN J OAQU 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 /> Nrice chests ❑ Refrigerator <br /> ❑ Refrigerated truck &'fce bath and tubs <br /> ❑Other(specify) <br /> 11. I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> ❑Three compartment sink. <br /> OR <br /> eThree deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br /> sol4ion(one tablespoon of bleach per gallon of water)_ <br /> etergent, 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 /> Erwater supply dispenser with warm water at a minimum of 100°F(i.e. 5-20 gallon container with spigot). <br /> e One separate tub(bucket or basin)for the collection of rinse/wastewater. <br /> [grPaper towels and pump-style soap container. <br /> 13. Names of r sponsible 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 /> preps d operation. Return original to festival coordinator three weeks prior to <br /> thi yen <br /> 14. Completed by: <br /> Signature Title ate <br /> 5-20 Gal. <br /> Lealth Per Hand wash Water <br /> LLL���� Stemo wiChaffing <br /> Dish <br /> Paper Hand Towels <br /> Soap dispenser <br /> Cutting Board <br /> Sanitizer bucket- <br /> bleach&water for <br /> Propane Stove Bleach storeg wiping cloths <br /> Booth must be on <br /> ❑ Concrete,Asphalt, <br /> Pfywood,or a Tarp. <br /> Propane Tank <br /> Soap are water Rinse Water Blearh and water Garbage <br /> Fire Extinguisher <br /> Can <br /> Extra <br /> Water <br /> ice Coolers ' S Gal Hand wash <br /> i Extra ke Bags 8 Food Cordakwrs must be Wastewater Container <br /> ....,-'t stored 6 inches off of the groundr <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 <br /> 07/3/17 TEMP EVENT APP <br />