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Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp <br />Title Date <br />5-20 Gal. <br />Hand wash Water <br />(z SANAOAQUIN ,\ 1 / <br />..- 1' <br />Environmental Health Department <br />v /- 10,0,Ra reotness grows here <br />41 <br />10. <br /> <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 />Ice chests Xi Refrigerator <br />El Refrigerated truck CI Ice bath and tubs <br />El Other (specify) <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />p. Three compartment sink. <br />V Three deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br /># s ution (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 />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />)g 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 />Names of responsible persons to be present in booth during all hours of operation: <br />—C OU N TV--- <br />OR <br />Cutting Board <br />Propane Stove <br />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 />is event <br />Signature <br />Paper Hand Towels <br />Sanitizer bucket- <br />bleach & water for <br />storing wiping cloths <br />"Important" <br />14. Completed by: <br />Health Permit <br />Sterno w/Chaffing <br />Dish <br /> <br />Soap dispenser <br />'> <br />Garbage <br />Can <br />Extra Ice Bags & Food Containers must be <br />stored 6 inches off of the ground! i <br />lce Cooler 5 Gal Hand wash <br />Wastewater Container <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sjgov.org/ehd <br />EHD 16-02 Page 8 of 11 TEMP EVENT APP <br />06/29/2023