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R EC-008 <br /> SAN JOAQUIN Environmental Health Department <br /> —COUNTY— <br /> in <br /> 10. 1 am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 45OF (if food is used the following day, maintain below 41 OF temperature): <br /> �] Ice chests ❑ Refrigerator <br /> ❑ Refrigerated truck X❑ 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 /> [l 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 /> Alrna r=r-tsR�4jo_.Gal=ter <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 /> this event. owner 4/19/2024 <br /> 14. Completed by: , ,�>•�-- <br /> Signature Title Date <br /> 5-20 Gal. <br /> Sterna w'ChalGng Hand wash W ale, <br /> Health Permit <br /> Dish Paper Hand Towels <br /> Saap tlispenscr <br /> Cutunp Baartl Sanill""buckel- <br /> bleach&water for <br /> Propane Stove Bleach slonhg wrpmg dot hs <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> Propane Tank <br /> - Soap and rialer Rinse wale, &each and Waler Garbage <br /> Can <br /> Fire bIrnquisher <br /> Ewtra <br /> W?[rr <br /> Ice Cooler 5 Gal Hand wash <br /> Extra Ice Bogs 8 Food Contaurers rnu9l be Wa6lewaler Container <br /> - ---------- Stored 6 inches 011 of the ground- <br /> 1868 E. Hazelton Avenue I Stockton. California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.orglehd <br /> EHD 16-02 Page 8 of 11 TEMP EVENT APP <br /> 06"19;19 <br />