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Health Permit <br />5-20 Gal. <br />Hand wash Water <br />( <br />Nose Water Bleach and Water <br />Cutting hoard <br />Garbage <br />Can <br />Stemo w/Chaffing <br />Dish <br />Soap Soap dispenser <br />Paper and Toweli <br />Saretuer bucket- <br />bleach & water for <br />stonng coping cloths <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />SAN JOAQUIN Environmental Health Department <br />- COUNTY <br />I 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 />Lii Ice chests Et Refrigerator <br />['Refrigerated truck ['Ice bath and tubs <br />El Other (specify) <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />RrThree 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). D Detergent, bleach, and wiping cloths (cleaning towels). <br />El Tub to store wiping cloths in bleach solution. <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />ZiWater supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />J One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />KPaper towels and pump-style soap container. <br />Names of responsible persons to be present in booth during all hours of operation: <br />61fe, <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 />Completed by: <br />Signature <br />;—) <br />Title Date <br /> <br />Ice Cooler <br /> <br />5 GM land .ash <br />Wastewater Container <br /> <br />&la /co Bags d food Confainors must So <br />dorod 6 Inchos off of filo groundl <br /> <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sjgov.org/elid <br />El-ID 16-02 Page 8 of 11 TEMP EVENT APP <br />06/19/19