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A • <br />REC-008 <br />Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br />Q Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />Q One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Q Paper towels and pump-style soap container. <br />13. <br />this event.Owner 07-17-202514.Completed by: <br />Title Date; -d l mO------ <br />Health Permit <br />Paper Hand Towels <br />Soap dispenser <br />Culling Board <br />BleachPropane Stove <br />0I <br />Bleach and WalerRinse Water <br />Fire Extinguisher <br />TEMP EVENT APP <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). <br /> Detergent, bleach, and wiping cloths (cleaning towels). <br /> 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 />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />Q Three compartment sink. <br />Extra fee Bags & Food Containers must be <br />stored 6 inches oft ol the ground' <br />Slerno w/Chaffing <br />Dish <br />Extra <br />Waler <br />5 Gal Hand wash <br />Wastewater Container <br />Garbage <br />Can <br />Sanitizer bucket- <br />bleach & waler lor <br />storing wiping dolhs <br />Booth must be on <br />Concrete. Asphalt, <br />Plywood, or a Tarp. <br />/| <br />Ice Cooler <br />_______I/ <br />Propane Tank <br />Names of responsible persons to be present in booth during all hours of operation: <br />Gurdial Singn <br />Baljinder kaur <br />•'Important** <br />SAN JOAQUIN <br />------COUNTY------ <br />Greotness grows here. <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 /> Ice chests Q- Refrigerator <br /> Refrigerated truck Ice bath and tubs <br /> Other (specify) <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420] F 209 464-0138 | www.sjgov.org/ehd <br />_ , -r-r—» r-iir-HT ArEHD 16-02 Page 8 of 11 <br />06/19/19 <br />rr r__Z <br />Soap and Waler <br />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 />|©Signed vu GovOS.com <br />__G c,_ <br />------1 Kej>-7dc5e7e«WS-S4»3MMIoiyiiaiuic <br />5-20 Gal. <br />Hand wash Waler