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Garbage <br />Can <br />Rinse Water Reach and Waler <br />5-20 Gal <br />Hand WaSh Water <br />Extra Ice Bags & Food Containers R71.61 be <br />stated 6 Plebes off of rho gleubril <br />Health Permit <br />Sterna %Chatting <br />Dish <br />Cutting Board <br />Propane Stove <br />Paper Hand Toweis <br />Sanitizer bucket- <br />bleach &waterier <br />scoring VOA! &OS <br />Soap dispenser <br />I <br />. Fire Extindulsher <br />Soap and Water <br />Ice Cooler 5 Gal Hand wash <br />Wastewaier Container <br />Booth must be or <br />Concrete, Asphalt, <br />PlyWOOd, OT a Tarp. <br />REC-008 <br />SA\ JOAQUIN Environmental Health Department <br />COUNTY <br />Grates5 grows liF.I.,, <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 followin , maintain below 41°F temperature): <br />[e chests Refrigerator <br />efrigeraled truck Ice bath and tubs <br />ther (specify) <br />rir providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />hree compartment sink. <br />OR -- <br />Rhree deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br />rffjtion (one tablespoon of bleach per gallon of water). <br />I - Detergent, bleach, and wiping cloths (cleaning towels). pub 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 />riAlater supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />ne separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Eraper towels and pump-style soap container. <br />Names of responsible persons to be present in booth during all hours of operation: <br />R 1..Th pr ( 0. e" -1-P- r- i 0.-1C7 r\- ./ <br />CI <br />"Important** All food vendor booths are sublect 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 />14. Completed by: <br />Signature <br />vvi-a_ SUBMIT <br />pat Title <br />1868 E. Hazel-ton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sigov.org/ehd <br />EHD 16.62 Page8 of 11 TEMP EVENT APP <br />08/18/19