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Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br />Water supply dispenser with warm water at a minimum of 100"F (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-stylo soap container. <br />13. <br />“Important** <br />Completed by14. <br />F’apur Hand Towels <br />Propano Stove <br />Prodans Tank <br />Soap anil Water <br />Fira extinguisher <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 />Exlia Icc Cays S rood Containers rmsl bo <br />stored 6 Inches ott nt llie ground! <br />blcmo v/IChalfing <br />Dish <br />5 Gel I land wash <br />Wastewater Container <br />Garbage <br />Can <br />Jtnnllizerbiickot- <br />biosch A water (or <br />storing wiping clolhs <br />Booth must bo on <br />Concrete. Asphalt, <br />Plywood, or a Taip. <br />Health Permit <br />( Extra \ <br />Water <br />SAN JOAQUIN <br />COUNT Y----- <br />,t ( ■( < rl 1 (H , , I/; Il< I i . <br />I am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br />45OF (if food is used the following day, maintain below 41UF temperature): <br /> Ice chests [^Refrigerator <br /> Refrigerated truck Ice bath and tubs <br /> Other (specify)_ __________________________________________________ <br />/ <br />Rlnso Water <br />I a>n providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />Mrhree 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 />1868 E. Hazelton Avenue | Stockton. California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjcehd.com <br />EHD 16-02 Pngo B of 11 TEMP EVENT <br />07/3/17 <br />Names of responsiblenersons to be present in booth duringjall hours nf operation: h /I * \ I \ 1 II 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 />Bteacli <br />Blaach and Watnr _____ <br />5-20 Gal. <br />«— Hand waih Water <br />| Soap itopenser | -------- - \