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» <br />Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br /> Waler supply dispenser with warm water al a minimum of lOO’F (i.e. 5-20 gallon container with spigot). <br /> One-separate tub (bucket or basin) for the collection of rinse/wastewater. <br />'aper towels and pump-style soap container. <br />13. <br />Completed by: 14. <br />Health Permit <br />Paper Ikiiwl Ttwels <br />Soap dispenser <br />Propane Stove <br />In — <br />Prupsnc Tank <br />Fire Exlinquishcr <br />IIce Cooler <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />Extra <br />Waucr <br />!> Qal H.vid wash <br />Wintewale* Coirtulraer <br />Garbage <br />Can <br />Seniftzcr bucko!- <br />bleach a waler lur <br />■jlniing w|rng detos <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />Stomn w't Piaffing <br />OHh <br />5-20 Gal <br />Hand wash Water <br />' • <br />falrn Icn ftw/s X Fond Contatoars must tm <br />storwi 6 fricbes off of tho nfouod! <br />SAN JOAQUIN <br />-COUNTY <br />I am^roviding the following items within my booth for the sanitary cleaning of food preparation utensil <br />[□'Three compartment sink. <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 />be present in^^thjiuri^al^^ operation: <br />Signature <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />EMO 16-02 PageSofll TEMPEVENT APP <br />06/201/2023 <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 /> Title U Date 1 <br />FT 7 <br />Soap and Waler <br />**lmpo riant** <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 /> Ipe chests [yzRefrigeralor <br />Ej Refrigerated truck Ice bath and tubs <br /> Other (specify) <br />Names of responsible persons to be pre: <br />Rinse Water <br />Culling Board