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5-20 Gal. <br />Hand wash Water <br />Paper Hand Towels <br />Health Permit <br />Stemo w/Chaffing <br />Dish <br />Soap dispenser <br />Sanitizer bucket- <br />bleach & water for <br />storing wiping cloths <br />Cutting Board <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />Propane Stove <br />Propane Tank <br />Rinse Water Bleach and Water Garbage <br />Can <br />Fire Extinguisher <br />Extra <br />Water <br />SAN JOAQUIN <br /> <br />Environmental Health Department <br />COUN —Y <br />10. 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 />rale chests gl-R—erNerator <br />El Refrigerated truck IN--lbath and tubs <br />III Other (specify) <br />11. I ampr5iding the following items within my booth for the sanitary cleaning of food preparation utensil <br />hree compartment sink. <br />OR <br />El Three deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br />sol (one tablespoon of bleach per gallon of water). <br />[Alte-rgent, bleach, and wiping cloths (cleaning towels). <br />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 />Dater supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />aOne separate tub (bucket or basin) for the collection of rinse/wastewater. <br />aper towels and pump-style soap container. <br />13. Nameof responsible ersons to ye present in booth during all hours of operation: ,.._) ... <br />e 5 _5(' e \--i, Li-cl <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 />preparatio • operation. Return original to festival coordinator three weeks prior to <br />this ev nt. <br />14. Completed by: <br />Signature Title Date <br />2-7 <br />( 7-6 <br />2,6/ <br />Ice Cooler <br />Extra Ice Bags & Food Containers must be <br />stored 6 inches off of the ground! <br />5 Gal Hand wash <br />Wastewater Container <br /> <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-34201 F 209 464-0138 I www.sjgov.org/ehd <br />END 16-02 Page 8 of 11 TEMP EVENT APP <br />riogi9n2z