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5-20 Gal. <br />Hand wash Water <br /> <br />Propane Stove <br /> <br />Booth must be on <br />Concrete. Asphalt. <br />Plywood. or a Tarp <br />DocuSign Envelope ID: A6E74685-DEDE-4900-90F6-8D6DC4F9DF9A <br />REC-008 <br />SAN JOAQUIN <br /> <br />Environmental Health Department <br />COUNTY <br />Greatness grows herc <br />10. 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 />>El Ice chests Refrigerator <br />LI Refrigerated truck Ice bath and tubs <br />LI Other (specify) <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />LI 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 />1=1 Detergent, bleach, and wiping cloths (cleaning towels). <br />Tub to store wiping cloths in bleach solution. <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />r] 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 />II] Paper towels and pump-style soap container. <br />Names of responsible persons to be present in booth during all hours of operation: <br />AlmA C a rter, Ryan CArtnr <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 <br />Signature Title Date <br />Completed by: <br />4/19/2024 <br />Soap arid Water <br />Extra Ice Bags & Food Containers must be <br />stored 6 inches off of the ground' <br />Health Permit <br />Guthrie Board <br />Sterno wChaf ring <br />DIsh <br />Soap dispenser <br />Bleach <br />Rnise Water Bleach and Water <br />5 Gal Hand wash <br />Wastewater Container <br />Paper Hand Towels <br />Sanitizer bucket - <br />bleach & water lot <br />storing wiping cloths <br />Garbage <br />Can <br />Li I <br />r <br />ice Cooler <br />1 Fee Extinguisher <br />1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 I F 209 464-0138 I wwvv.sjgov.orglehd <br />END 16-02 Page 8 of 11 TEMP EVENT APP <br />0619119