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r <br /> DocuSign Envelope ID: F7EBABOF-7596-4099-AFOB-7F85FD491F53 <br /> �auit; <br /> SA N ]U A U 1 N Environmental Health Department <br /> C O U N T Y— <br /> Ir_,,,,,++s Greatness grosys Mere. <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 /> F]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. 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 original to festival coordinator three weeks prior to <br /> ft+av"lt. <br /> 14. Completed byf N Owner 5/23/2024 <br /> FE1! 0,DO-907A7F... Signature Title Date <br /> 5-20 Gal. <br /> Health Permit Hand wash Water <br /> Slarno wlGhaiTrsg <br /> Dish <br /> Paper Hand Towels <br /> Soap dispenser <br /> Culling Board Sanilizer bucket- <br /> bleach&water for <br /> Propane 5[ove Bleach storing wiping cloths <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> Prgpanq Tank <br /> 9gap and Water Rinse Water ateach and Water Garbage <br /> Can <br /> at Fire EzEtnpuisher <br /> Erlra <br /> Water <br /> Ice Cooler 5 Gal Hand wash <br /> Extra Ice Rags&Food Containers must be Wastewater Container <br /> slored B inchas off of the ground! <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 T 209 468-3420 1 F 209 464-0138 1 www,sjgc)v.org/ehd <br /> EHD 16-02 Page 8 0111 TEMP EVENT APP <br /> 06f29f2023 <br />