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S A N J O A Q U I N Environmental Health Department <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 F Refrigerator <br /> 0 Refrigerated truck ❑ Ice bath and tubs <br /> ❑ Other(specify) <br /> 11. I 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 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 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 /> Joe Spencer <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 even <br /> 14. Completed by: Owner/Operator 06/06/2015 <br /> Signature Title Date <br /> 5-20 Gal. <br /> Health Permit Hand wash Walmi <br /> Slerno wiChaffing <br /> Dfsh <br /> Paper Hand Towels <br /> Soap dispensmr <br /> Cuffing board Sanitizer bucket- <br /> bleach S wolor for <br /> Plopana Sfove Bleach storing vaping cloths <br /> Booth roust be on <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> ------------ <br /> Soep and Welar Rinse water Bleach and Water Garbage <br /> Can <br /> Fire Extinguisher <br /> Ex!ra <br /> water <br /> Ice Cooler 5 Gal Hard wash <br /> zlra lce Rags 6 Food Coniarners Must be Wastewater C,onta'nar <br /> siorpd 6 lnChas off of the ground! <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 T 209 468-3420 1 F 209 464-0138 j www.sjgov.org/ehd <br /> EHD 16-02 Page S of 11 TEMP EVENT APP <br /> 06/19119 <br />