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Environmental Health Department <br />10. <br />11.Hems within my booth for the sanitary cleaning of food preparation utensil <br />OR <br />12.htng facilities, but separate from utensil wash within my <br /> Water supply dispenser with warm water at a minimum of <br /> Paper towels and pump-style soap c jntainer. <br />13 <br />“Important** <br />a cop:»f this <br />14.Completed by. <br />Is Date <br />Health Permit <br />PdpCI H.WJ lu'M'h <br />Stwp <br />Pftwne Stw Htascr. <br />7 X! Pt wane Tank <br />Ulc.net> nnc VteiwSoap anu W. itr Qrfyj’ Waler <br />r»C <br />8 <br />Stemo »c!ChaHn§ <br />5-80 Cai <br />Ityxj wosn w.ntnr <br />Garbage <br />Can <br />Booth must be on <br />Concrete. Asphalt. <br />Plywood or a Tarp <br />I am | <br />booth: <br />Sturtizcr busker- <br />bmacn A water far <br />taring xwptng aoths <br />Cxtrj tetf Sj<75 A Ftxid Conform rrznt x? <br />sturttf 6 omtss ott or tne tjrouna1 <br />'.k‘ <br />/ Cisa \ <br />WjSw <br />pei^r^jp bepre sent in booth during all hours of operation: <br />minijihum). one for soapy water, one for rinsino and one for a bleach <br />Jlpn/fyrater). <br />&h^afnRQ towels). <br />ihn' <br />providing the following for adequ ate hand w <br /> Three deep tubs (basins 6-8 <br />solution (one tablespoon of bleach pert q <br />LJ Detergent, bleach, and wiping cloths (u.« <br /> Tub to store wiping cloths in bleach < oluni <br />I am providing the following^ <br /> Three compartment sink. <br />checklist must be in the booth at all hours of <br />1 to festival coordinator three weeks prior to <br />Title Date A <br />All food vendor boolf s are subject to inspection. Please make a copy of this application in <br />preparation for this event. \ * -----n ' - - • •• <br />pre^rationyand opecsjfon.? <br />/ ^gnature <br />SANJOAOUIN <br />----COUNTY------ <br />Grcafncss qrc^i hfr?, <br />' le™peralure contral (or lhe coid Holding of potentially hazardous foods below <br />food is used the following day. maintain below 41 eF temperature): <br />U Ice chests Refrigerator <br /> Refngerahs^Hruck [j Ice bath and tubs <br /> Other (specifyN. __________ <br />5 Gal Hann wusn j ________f <br />WrtMuwain Cont.»nci——41 L_--------J <br />Hazelton Avenue | Stockton. Californ a 95205 | T 209 468-3420 I F 209 464 >0138 I imvuiw <br />Ice Cooler <br />•O F (i.e. 5-20 gallon container with spigot). <br /> One separate tub (bucket or basin) for the collection of rinse/wakewater.