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z'o�4`acaz�; SANvJOAQUIN Environmental Health Department <br /> COUNTY— <br /> �c�� 1 Greatness grows here. <br /> 10. W 1 am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 450F (if food is used the following day, maintain below 41°F temperature). <br /> IN Ice chests ❑ Refdgerator <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 /> 5d Three compartment sink. <br /> OR <br /> ❑ 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 hnselwastewater. <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 /> Octavio Alegria <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 o eratio Return original to festival coordinator three weeks prior to <br /> this event. a <br /> 14. Completed by.- �- Representative 1 1-12-25 <br /> Sign ture Title Date <br /> i <br /> 5-4i7 Gal <br /> Health Per Hand wash Water <br /> Stemo wlChafRng <br /> Paper Hand Towels <br /> Soap disponsor <br /> Cutting Board Sanrtzzer bucket- <br /> bleech&water for <br /> propane Stove Bleak storing wiping cloths <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> Prcpana Tank <br /> soap end water Rinse Water tBeaeh and water Garbage <br /> Can <br /> Fife Extinguiahor <br /> �Si. EKlra <br /> Water <br /> Ice Cool ef 5Gal Hand wash <br /> 7E.1idBags 8 Food containers must be Wastewater Contaches offal the ground' <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 l T 209 468-3420 l IF 209 464-0138 1 www.sjgov.org/ehd <br /> EHD 16-02 Page B of 11 TEMP EVENT APP <br /> 07/0112025 <br />