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S A N J O A Q U IN Environmental Health Department <br /> —00UNi' Y <br /> 61'00 rless gvosys here <br /> 10. 1 am providing the following cold temperature control For the cold holding of potentially hazardous foods below <br /> 45'F (if flood is used the following day, maintain below 41'F temperature), <br /> �( Ice chests ❑ Refrigerator <br /> ❑ Refrigerated truck ❑ Ice bath and tubs <br /> Other(specify) e 1' <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 /> olution (one tablespoon of bleach per gallon of water) <br /> Detergent, bleach, and wiping cloths(cleaning towels). <br /> ATub 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 /> 10One 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 /> a CA I Z -- - — <br /> V , C r-- (-. <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 vent. � <br /> 14. Completed by: <br /> Signature Tit a Date <br /> Health Permit Hand wash Water <br /> P St.wrcnartmp <br /> oish <br /> Paper Hand Tcwe; <br /> Soap dispenser <br /> Cud�np Board Swidxer bucket <br /> ac - <br /> bleh&water for <br /> Propane Slove Ihr,.,i storing wiping cloths <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Plywood,of a Tarp <br /> PrIX)ane lank <br /> Soap and Water R.nse Waler Bleach and Wales <br /> Garbage <br /> Can <br /> Fire E�clmgushnr ._ <br /> Ice Cooler bGAI 1a 1wash <br /> Dire Ice Baps 6 F000 C fwnere nws!be Wasluwaier Co"Ida, <br /> a r <br /> - MoredP 0 mchon oliof the pround! <br /> 1868 E Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 IF 209 464-0138 1 www.sjgov orglehd <br /> FHD 16-02 Page 8 of 11 TEMP EVENT APP <br /> n7Ma r�n.. <br />