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r <br /> SAN JOAQUIN Environmental Health Department <br /> 10. 1 am providing the following cold temperature control for the cold holding of potentially hazardous foods helow <br /> 45'F (if food is used the following day, maintain below 41'F temperature): <br /> ❑ Ice chests © Refrigerator <br /> ❑ Refrigerated truck ® Ice bath and tubs <br /> ❑ Other(specify) <br /> 11. 1 am providing the following items within my boots for the sanitary cleaning of food preparation utensil <br /> © Three compartment sink. <br /> OR <br /> ❑ Three deep tubs (basins 6-8 inches minimu-n), 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 rinselwastewater. <br /> ❑ Paper towels and um -st le soa container. <br /> 13. Names of responsible persons to be present in booth during all hours of operation: <br /> Frank Teixeira <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 on lnal to festival coordinator three weeks prior to <br /> this event. <br /> 14. Completed by: Sondra M. Berchtold Office/Catering Manager 3/24/25 <br /> Signature Title Date <br /> 1 2 Gal. <br /> Hand xuvli Walo, <br /> Health Permit sie„rowrcr,arr«.p <br /> C Pay_r Hnod Towels <br /> Soap diGpepser <br /> iariing Guard sanluzer buckol- <br /> Wach a—ier lcx <br /> arrux;ry wiping rlcrhs <br /> Booth must be on <br /> O Concrete,Asphalt, <br /> Plywood.or a Tarp. <br /> 1\ <br /> Soap wd Waicr I Itinsu Wa[ei 91ddGh)Wwu, Garbage <br /> L Can <br /> r v,•t•:,mtish•cr <br /> Eur <br /> at wa;cr <br /> Ice Cooler 3calr+arwwash <br /> E.tra Ice 84Ts S Food Ccwame s mat he Wastewarc, <br /> 4.--d f mcA—oR 0 Ow gn,:md, <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.orglehd <br /> Ewtr 1r tr, !sryr.8 of 11 TEMP EVENT APP <br />