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10. <br />I ai11. <br />OR <br />12. <br />Water supply dispenser with warm water at a minimum of lOOT (i.e. 5-20 gallon container with spigot). <br /> One separate tub (bucket or basin) for the collection of rinse/wastewater. <br /> Paper towels and pump-style soap container. <br />13. <br />Completed by:14. <br />Pap« Hand Towals <br />Sojp diapmsor <br />CuUHifl Boa/d <br />BlsactiPropane Slow <br />it J '■ <br />Prooorro Tank <br />Rn» tubngn.-si'f* <br />Ice Cooler <br />TEMP EVENT APP <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />rfoviding the following items within my booth for the sanitary cleaning of food preparation utensil <br />ree compartment sink. <br />Exira <br />Waw <br />5 Gal Hand wash <br />Wastewater CoiSahwr <br />Booth must lie on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br /> Three deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br />solulion (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 />Stmno wi'ChaHtng <br />Didi <br />S-20 Gal. <br />Hund wash WaWi <br />Garbage <br />Can <br />San'lircr buckat- <br />bteadi 4wt)t«r fol <br />■anring wiping doll's <br />| Health Permit | <br />(p «v— <br />Signature <br />**lmportant** <br />fxfra fco Ztogs A Erwd Corifoirwra i»i«l txr <br />storud 6 vtetos off of foe gnxuxff <br />VHH d vn^ VI It <br />-COUNTY <br />IT L7 <br />Soap and Water <br />it <br />iilnso Wiitor <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 Refrigerator <br /> Refrigerated truck Ice bath aniltubs <br />ET^ther (specify)____________f ' c v ] /r- <____________________________________ <br />Names of responsible persons to be present in booth during all hours of operation: <br />_____■ tk/v ft C I __________________________________ <br />— I <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 Date <br />1868 E. Hazelton Avenue I Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />EHD 16-02 Page 8 of 11 TEMP EVENT A! <br />06/2»2023