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S A N 1 oA Q U I N Environmental Health Department <br /> 10. 1 am providing the following cold temperature control for the gold holding of potentially hazardous foods below <br /> 457 (if food is used the following day, maintain below 41°F temperature): <br /> ❑ Ice chests ❑ Refrigerator <br /> ❑ Refrigerated truck i ❑ 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 /> 1�1 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 tnwols and um -style soap container. <br /> 13. Names of responsible persons to be present in booth during all hours of operation: <br /> j4i <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: <br /> tgnature Title Date <br /> E�ia"S-:40 Gal.Health Permit �� avatar <br /> Sremo wiUafflng <br /> pisit <br /> Pa,er"anti Towgls <br /> Soap aisppr};car <br /> Cut:np poard <br /> S&)alrZf3r puckal- <br /> b�aarh 6 water for <br /> Arapanq Sloae 91Fat1+ Fionr+p wiling datlts <br /> Booth must be on <br /> ❑ Concrete,AsphaO, <br /> Plywood,or a Tarp, <br /> reupanc ra,tti I - <br /> Snap and Waler Rin�q Wat4r Nana and Wale! Gaf ge <br /> i <br /> Flra Eztiniruisr�cv Can <br /> F.!n <br /> VJater <br /> Ice Cooler I r <br /> ' s as rruu waon <br /> j r Cxtm ke Baps 6 Fgog Corrtarners must de - Waglewaler Ggntarrtor <br /> -.- -- - sfww 6 mches ofror the ground, - <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 j T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/ehd <br /> EHO 1"2 Page a of 11 TEMP EVENT APP <br /> 07/0112024 <br />