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5 Gal Henri wash <br />Wastewater Container Extm ice Bags & Food Containers must he <br />siored 6 inches off of the _mend! <br />Culling Board <br />Propane Stove <br />Tie <br />Soap dispenser <br />Dale <br />Paper Hanyi towels <br />Sanitizer bucket- <br />bleach &water for <br />storing wiping cloths <br />Signature <br />Sterne w/Chaffing <br />oish <br />5-20 Gal. <br />Hand wash Water <br />Rinse Water <br />Fire Extinguisher <br />Bleach an Water Oarbage <br />Can <br />Ice Cooler <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />Extra <br />Water <br />REC-008 <br /> <br />SAN JOAQJIN Environmental Health Department <br />-- <br />i. iler!?: <br /> <br />10. I am providing the following cold temperature control for the cold holding oi potentially hazardous foods below <br />4 <br />Ic <br />5°F (if food is used the followin , • . <br />. <br />11 <br /> <br />rill Ref riaginetraaiinorbelow 41°F temperature): <br />ther (specify) <br />chests <br />efrigeraled truck lice bath and tubs <br /> n <br />providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />hree compartment sink. <br />OR <br />Three deep tubs (basins 6-8 inches minimum), one for soapy wafer, one for rinsing and one for a bleach <br />[—Ilion (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 ray <br />booth: <br />riNater supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />rkne separate tub (bucket or basin) for the collection of rinse/wastewater. <br />'aper towels and pump-style soap container. <br />Names of responsible persons to be present in booth during all hours of operation: <br /> <br />C-7)04 10YA r --1,:0'011\f‘eA , tr\--rk r/rY101 V-) <br />iA15 <br /> <br />&wYCA(Inc--1,c7) <br /> <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 ope a-lion. Return original to festival coordinator three weeks prior to <br />Completed by: 4\ OZ,S)2 SUBMIT <br />1868 E. Hazellon Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sigov.org/ehd <br />EHD 16-02 Pageaelii TEMP EVENT APP <br />06/19119 <br />this even