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R EC-008 <br /> sA N oa Q u Environmental Health Department <br /> COUNTY <br /> 10. 1 am providing the following cold temperature control for the cold holddrng of potentially hazardous foods below <br /> 450F (if food is used the following day, maintain below 41 of temperature): <br /> U 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 /> [I 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. I 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 100OF (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-slyie soap container. <br /> 13. Names of responsible persons to be present in booth during all hours of operation: <br /> olala rartRr Ryan rarter <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: e <br /> Signature Title Date <br /> r <br /> 5.20 Gal. <br /> Hand wash water <br /> Health Permit <br /> 5terno w Chan rig <br /> dish <br /> Paper Hand Towels <br /> Soap dispenser <br /> Cu[IinQ tlOdrd Sard,Zer bu[ket- <br /> bleach&water for <br /> Prepare Sloe bleach storing Moping Moths <br /> Booth must be on <br /> n Concrete.Aspha4, <br /> {lJl Plywood,Ora Tarp. <br /> Prepare Tank <br /> Soap and Warer R,nsa Water Neani and Water Garbage <br /> Can <br /> Fve Exhugu�shar <br /> Eata <br /> W aler <br /> fce Cooler l 5 Gal Hand wash <br /> �V Ertra ice Bogs&Focdcontanversrrrusrbe Wastewatercantamer <br /> stored 6 ruches 00 or the groundr <br /> 1868 F. Hazelton Avenue I Stockton, California 95205 T 209 468-3420 F 209 464-0138 1 www.sjgDv.orgyehd <br /> EHD I6-02 Page B o1 I t TEMP EVENT APP <br /> 06.'19'19 <br />