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SAN JOAQUIN Environmental Health Department <br /> COU N I Y <br /> l. ,:111 '1 •,1. 1 i .'.4 1, <br /> 10. 1 am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 45eF (if food is used the following day, maintain below 41°F temperature): <br /> ❑ Ice chests El Refrigerator <br /> ❑ Refrigerated truck ❑ Ice bath and tubs <br /> [,Other(specify) rte r <br /> 11. dam providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> 1]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 /> ❑Water supply dispenser with warm water at a minimum of 100eF(i.e. 5-20 gallon container with spigot). <br /> ❑ One separate tub(bucket or basin)for the collection of rinsetwastewater. <br /> 0 Paper towels and pump-style soap container. <br /> 13. Names of responsi le person to be present in booth during all hours of operation: <br /> 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_t_o <br /> this eve ik., <br /> 14. Completed by: <br /> Sig ature Title Date <br /> .r� 5-20 Gal. <br /> Health Permit ItendwashWriter <br /> Sterna wfChafhng <br /> nun <br /> Paper Hand Towala <br /> Soap dispenser <br /> Cutting Board Sandizar bucket. <br /> bleach d water For <br /> Propane Slave Bleach glaring wilping cloths <br /> Booth must be on <br /> O Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> Propann Tnnk <br /> Seep and Waler Rinse Water llteach and Walar Garbage <br /> Can <br /> Fire Ezlinguishcr <br /> Gxlra <br /> Wa[ar <br /> Ice Cooler ..r,, 5 Gal Hand wash <br /> Extra rice(tags&Food Containers mast bo Wastewater COraaMler <br /> stored 6 inches off of the gfourhdl <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/end <br /> EHR 16-02 Page 8 of 11 TEMP EVENT APP <br /> 06/19/10 <br />