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P, wane Star. I <br />Pch riuNI be tin <br />Corr./ ete, Asrbe <br />Fiyiabixil. 0- a TalP <br />SAN JOAQUIN --couNTv_ Environmental Health Departrnent <br />I 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 />0/3-toe chests oRefrigerator <br />P Refrigerated truck 0 Ice bath and tubs <br />0 Other (specify) <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />41-Three compartment sink <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth; <br />f2Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />421-011e separate tub (bucket or basin) for the collection of nnsetwastewater <br />.0-Paper towels and pump-style soap container. <br />Names 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 ;!-, checklist must be in I"- booth at all hours of <br />prepar and operation. Return original to festival coordinator three weeks prior to <br />this 'nt. <br />Signature <br />OR <br />cgi-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 />2fliejtergent, bleach, and wiping cloths (cleaning towels) <br />b to store wiping cloths in bleach solution, <br />14 Completed by (1—t <br />Title Date!t <br />5-20 Cal <br />eertr Waw <br />Stema .../Chaelng <br />.3 Watt. <br />Ice Cooler <br />raI3 Cerof rount <br />: • • <br />C.arHg <br />1868 E. Ha/0ton Avenue 1 Stockton CBMMia 95205 T 209 468-3420 F 209 4-0t3 www sraryv crv'etrd <br />EHO te-02 Pagi,iVjoflt <br />TEMP eveur <br />06/20/2023