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SAN ,IOAQUIN Environmental Health Department <br /> —COUNTY-- <br /> Greatness grows here. <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 /> ❑x 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 /> ❑x 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 /> 0 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 pump-style soap container. <br /> 13. Names of responsible persons to be present in booth during all hours of operation: <br /> Amber Synha <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 event. <br /> 14. Completed by: Malllo�y C( &h __ Director of Catering and Evcros 616./25 <br /> Signature Title Date <br /> 5.20 Gal. <br /> Health Permit Hantl wash Water <br /> Stoma wlChaff rig <br /> Dish <br /> Paper Hand Towels <br /> Soar dispenser <br /> Gutting Board Sanihzer buckot- <br /> Nooch B wator far <br /> Propane Stove Bleach storing wiping cloths <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> Propane Tank <br /> Soap and Water R2 30,0vatef Bleach and Water J Garbage <br /> Can <br /> Fire Extinguisher <br /> • Extra <br /> �t" ' Water <br /> �`yAli <br /> ice Cooler 5 Gal Hand wash <br /> Extra tce Rags 8 Food Containers mull 6e Wastewater Container <br /> --• slorod 6 wrhas off of the ground? <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 T 209 468-3420 F 209 464-0138 1 www.sjgov.org/ehd <br /> EHD 16-02 Page 8 of 11 TEMP EVENT APP <br /> 0710112024 <br />