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SAN JOAQUIN Environmental HeaKh Deparr�rnent <br /> —COUNTY <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 /> ® Ice chests ❑ Refrigerator <br /> ❑ Refrigerated:ruck ❑ 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 /> ZI 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 /> M 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 dispenserwith warm water at a minimum of 1007(i.e. 5-20 gallon container with spigot). <br /> ❑One separate tub(bucket or basin)for the collection of rinse/wastewater. <br /> 29 Paper towels and pump-style soap container. <br /> 13. Names of responsible persons to be present in booth during all hours of operation: <br /> Richard Rose 408-607-8058 <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 atin. Return original to festival coordinator three weeks prior to <br /> this event. <br /> 14. Completed by: •� Coordinator 04/15/2025 <br /> Signature Title Date <br /> Health P2rmlt <br /> sterrto tisA-.liatG�g <br /> Dish <br /> Paa�H Hero]Ycwes <br /> Soap dispenser <br /> Culling 9eud Sanlltzer bucker, <br /> bleach&water Tr <br /> Propane SloVe 131enh alonng wiping cloths <br /> Booth must be on <br /> _O _ Concrete,Asphalt, <br /> Ptcpaaa Tar* Plywood,or a Tarp. <br /> I <br /> Saap and Y: Ri alcf nse WeEr1 aearh and l Water Garbage <br /> Can <br /> Flre;.mirguisher <br /> Ekra <br /> f�+ We1ef <br /> IGe 01e r1 r SGN and w.rn <br /> Extra lee daps a Food Conlafnc must b. 54'av_Iar Cantahe r <br /> ..._ .— sfued 6 inrles a alhe gmurrdl <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 i T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br /> SHD 1&4D2 Page B of 9# TEMP EVENT A PP <br /> 07iM 7 <br />