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S A NJ O A Q U I N Environmental Health Department <br /> COUNTY <br /> Grcotness rlrowN horc <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°F temperature): <br /> Q Ice chests ❑ Refrigerator <br /> ❑ Refrigerated truck ❑ 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 /> [,;� Three deep tugs (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 /> Kafhalaan Ramhn-C:amarilln <br /> Samantha Ouk <br /> **Important** All food vendor booths are subject to inspection. Please mane 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. 1�L�� <br /> 14, Completed by: 91xr _ GFo 4/18/24 <br /> Signature Title Date <br /> 5-20 Gal. <br /> Health Per Hand wash Water <br /> Stems wlChaffing <br /> Dish <br /> Paper Hand Towels <br /> Soap dispenser <br /> Cutting Bnard Sarlazer bucket- <br /> bleach R water for <br /> Propane Stove <br /> Bleach storing wiping cloths <br /> Booth must he on <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> r: <br /> Propane Tank <br /> Soap and Water Rinse Water Bleach and Water Garbage <br /> Can <br /> Fire Extinquiaher <br /> Extra <br /> Wafer <br /> Ice Cooler 5 Gal Hand wash <br /> Extra ice Begs B flood Contamers a wst be Wastewater Container <br /> ---- stored 6 inches off of the groundf <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 T 209 468-3420 [ F 209 464-0138 j www.sjgov.org/ehd <br /> EHD 16-02 Page 8 of 11 TEMP EVENT APP <br /> OW2912023 <br />