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j <br /> S A N J Q A 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 /> 45OF(if food Is used the following day,maintain below 41 OF temperature): <br /> RL 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 /> .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 Goths(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 /> ;R 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 /> "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 /> JtNL@vent. <br /> 14. Completed by: <br /> Signature Title Date <br /> sza Gat. <br /> Health Permit 'a"di" m Water <br /> stemo VChef ft <br /> oisn <br /> Pape nand To+nsels <br /> Seep dncperaer <br /> drifina Board sarutkerbuduit- <br /> Mach d water for <br /> Pmpa�Steve Bleach aftw"Wphg cloths <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Plywood, r a Tarp. <br /> Propene Tank <br /> y—and Water Rinse Wemr Btsadr and Watrsr 9 <br /> Garbs e <br /> Can <br /> .. r- RMeffingulsher <br /> waea< <br /> 1 <br /> Ice Cooler 5 Gal Hand wash <br /> 6"fee&ags a Food comarnem m=de wasFanater cantainex <br /> ahxad s h�ahes otlW the�acard? <br /> 1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 I F 209 464-0138 1 www.sigov.org/ehd <br /> EHD 16-02 Page 8 of 11 TEMP EVENT APP <br /> 08119M <br />