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REC-008 <br /> S A Environmental Health Department N J OA QU IN <br /> 0 U 1\1 T Y- <br /> 10. 1 am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> IF(if food is used the followin, aintain below 41 IF temperature): <br /> .c Refrigerator <br /> Ref" <br /> e chests T geralor <br /> Refrigerated truck Ice bath and flubs <br /> Other(specffy)- <br /> 11, II i roviding the following items within my booth for the sanitary cleaning of food preparation utensil <br /> I ,A _ree comparlment sink. <br /> OR ahree deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br /> �etergent, <br /> ion (one tablespoon of bleach per gallon of water). <br /> bleach, and wiping cloths(cleaning towels) <br /> EJub 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 /> [ later supply dispenser with warm water at a minimum of 1 OOOF(i.e. 5-20 gallon container with spigot). <br /> [6�/neplarale tub(bucket or basin) for the collection of rinse/wastewater. <br /> e <br /> aper towels and pump-style soap container. <br /> 13. 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 appiicatron in <br /> preparation for this event. A copy of this checklist must be in the booth at all hours of <br /> preparation and to eration. Return original to festival coordinator three weeks prior to <br /> this,even i. <br /> 14. Completed by: ej,?r SUBMIT <br /> V U � ignalure Title Date <br /> 5-20 Gal. <br /> Handwashwater <br /> Health Permit <br /> Sterno wChalting <br /> Dish Paper Hand Towels <br /> Soap dispenser <br /> Cultinp Board sanifixer bucket- <br /> bleach&waterfcr <br /> Bleach storing YAp(nj cloths <br /> Propsnestave <br /> Booth must be o;] <br /> Concrete,Asphalt <br /> Plywood,or a Tarp. <br /> Soap snil Water Rinse Water Bleach anal Wale( <br /> Garbage <br /> Can <br /> Fire Extin4uisher <br /> Extra <br /> Water <br /> 0or <br /> Ice Cooler 5 Gal Han,wash <br /> ) Exka me Bags Food ConlaMrs must he wastewaterc.nWrier <br /> ........... sjoffld 6 kWhas o/f of the groun <br /> 1 <br /> 1868 E.HazeltQn Avenue I Stockton,Caliiomia 952051 'r 209 468-3420 IF 209 464-0138 www.sjgov.org/ehd <br /> EHD 16-02 Page 8of 11 TEMP EVENT APP <br /> 00119119 <br />