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,611 <br /> SA6JOAQUIN Environmental Health Department <br /> COUNTY <br /> �f� g� 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 OF temperature): <br /> ❑ Ice chests ❑M Refrigerator <br /> ❑g 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 /> ❑ 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 dnse/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 /> Frank Teixeira <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. Retum original to festival coordinator three weeks Prior to <br /> this event. <br /> 14. Completed by: Sondra Berchtold Office Cordinator 117/26 <br /> Signature Title Date <br /> 5-20 Gal. <br /> Health Permit Hand wash Water <br /> Stemo wfChafng <br /> Dish <br /> Paper Hand Towels <br /> Soap dispenser <br /> Cutting Board Sanitizer budcet- <br /> bleach R water for <br /> Propane Stove Bleachstoring wiping doths <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> Propane Tank INS <br /> Soap and Water Rinse ater Desch and Water Garbage <br /> Can <br /> Fire Extingulsher <br /> Extra <br /> water <br /> Ice Cooler 5 Gat Hand wash <br /> FVra Ace Baps d Food containers muss be Wastewater Container <br /> stored 6 ruches olfo/fire ground! <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/ehd <br /> EHO 16-02 Page 8 or 11 TEMP EVENT APP <br /> 06/19/19 <br />