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Ptopao Shsva <br />PB 04/17/2024 Manager <br />Soap dIspeoso( <br />Papa( Hani lowals <br />Title Date <br />Gal. <br />Hand wash %Valor <br />21inaiure <br />Slam) KIhnlfing <br />ulsh <br />rice Cooler <br />"Important" <br />Completed by: <br />All food vendor booths are <br />preparation for this event. <br />preparation and operation. <br />this event, <br />Rawad Annan <br />subject to inspection. Meese make a copy of this application In <br />A copy of this checklist must be In the booth at all hours of <br />Return oriainal to festival coordinator three weeks prior to <br />snap nn Wfilor nintoWnlor 131ancli nAd WOWr Garbage <br />Can <br />Ufa <br />Walor <br />CtilUnp Board aohlzar bockal- <br />blood, t, wmortor <br />s!oring ktApng cblhs <br />S OM Hand wash <br />Wootthmtot ConinInor <br />Health Permit L <br />EtilAca Vaps S Food conmtnots lop/ ba <br />maw/0 Mots off 01 /11BD/60nd) <br />B0001111USt be on <br />Comrete, ABphali. <br />Plywood, ore Tem. <br />R EC-008 <br />, <br />Pe.) <br />SA JOAUIN <br />Environmental Health Department <br />C UNTY— <br />‘•1/ r, „v,i.,\''.... Giel.it1H3$ 5 9 I° ws here. <br />10. I am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> <br />5°F (if food Is used the followin , maintain below 41°F temperature): <br />Ice chests Refrigerator <br />elrige rat ed truck ice bath and tubs <br />ther (specify) <br />11,providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />Illireo compartment sink, <br />Three deep tubs (basins 6-8 inches minimum), one (or soapy water, one for rinsing and one for a bleach <br />If on (one tablespoon of bleach per gallon of water), <br />I Detergent, bleach, and wiping cloths (cleaning towels). <br />rub to store wiping cloths in bleach solution, <br />12. I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />riNater supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />FlJne separate tub (bucket or basin) for the collection of rinse/wastewater. <br />rl'aper towels and pump-style soap container, <br />Names ol responsible persons to be present In booth during all hours of operation: <br />186E3 F. Hazeiton Avenue I Stockton, California 05206 I T 209 468-3420 I r 209 464-0138 I www.sjgov.org/elid <br />EI-10 16,02 Page pi Ii TEMP EVENT APP <br />08119119 <br />OR 7