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S A N ! OA Q U i N Environmental Health Department <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 /> 9 Ice chests ❑ Refrigerator <br /> ❑ 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 /> ❑ Three compartment sink. <br /> OR <br /> E 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 /> Shyan Carter <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: ¢'Z, C�A'+- <br /> Event Coordinator 2/15/2026 <br /> Signature Title Date <br /> 5-2o Ga]- <br /> Health Permit HandwashWater <br /> Stemo wlChaffing <br /> Dish <br /> Paper Hard Towels <br /> Soap dispenser <br /> Cutting Board Sanitizer bucket- <br /> Neach a water for <br /> Bleach <br /> storing wiping cloths <br /> Propane Stflve <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Plywood.or a Tarp. <br /> Propane Tank <br /> %Sv?�" Seap and Wafer Rinse Water Bleach ana Water <br /> Garbage <br /> Can <br /> Fire I-Anguisher <br /> Fxtra <br /> Water <br /> Ice Cooler 5 Gal Hand wash <br /> Extra ice Bags 8 Food Containers must be Wastewater Container <br /> stored 6 tncOes off of the grounds <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 � F 209 464-0138 1 www.sjgov.org/ehd <br /> EHD 16-02 Page a of 11 TEMP EVENT APP <br /> 07/0112024 <br />