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R EC-008 <br /> SAN JOAQUIN Environmental Health Department <br /> COUN F Y- <br /> 10. 1 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 aF 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 /> [3 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 /> Alma rartor Pynn rartor <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: A — <br /> Signature Title Date <br /> 5-20 Gal. <br /> Health Permit Hand wash Water <br /> Slarno w:Chatfing <br /> Dish <br /> Paper Hand Towels <br /> Seep dispenser <br /> Cutting Board Sanitize'bucket- <br /> bleach S water f1\ <br /> or <br /> Propane Slave Bleach slanng wiping cloths <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> Propane Tank <br /> Soap and Water Arose Water 9ieach end Water Garbage <br /> Can <br /> Fee Extinguisher <br /> �rira <br /> Wsler <br /> Ice Cooler { 5 Gal Hatxl*ash <br /> Exux ice Rags 6 Food Contarrors rtaut be Wasleralef Gardiner <br /> stored 6 irWies oiro7rhe ground.t <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/ehd <br /> EHD 16.02 Page 8 of 11 TEMP EVENT APP <br /> 06,'1W19 <br />