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Environmental Health Department <br />N/A <br />11. <br />OR <br />12. <br />[XWater supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />13. <br />^Important** <br />1-19-2414.Completed by: <br />Title Date <br />Health Permit <br />Papar Hand Towols <br />Soap dispenser <br />Cuttlnp Board <br />BleachPropane Slovn <br />Bleach and Water <br />Fira Extinguisher <br />Ice Cooler <br />TEMP EVENT APP <br />\ . <br />One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />X] Paper towels and pump-style soap container. <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 /> Three compartment sink. <br />Extra tea Bags & Food Containers must bo <br />stored 6 Inches oil of the ground! <br />Exira <br />Wator <br />5 Gal Hand wash <br />Wastewater Container <br />5-20 Gal. <br />Hand wash Waler <br />Garbage <br />Can <br />Sanlllzar bucket­ <br />bleach a waler for <br />storing wiping cloths <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, ora Tarp. <br />X 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 />V) Detergent, bleach, and wiping cloths (cleaning towels). <br />•Q Tub to store wiping cloths in bleach solution. <br />Names of responsible persons to be present in booth during all hours of operation: <br />Bret-Casey-------------------------------------------- <br />Stomo w/Chofling <br />Dish <br />Jayn<a Casey <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 />this event owner <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />RHO 16-02 Page 6 of 11 TEMP CVENT A! <br />06/19/19 <br />■^SANJOAQUIN <br />------COUNTY------- <br />Greatness 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 Refrigerator <br /> Refrigerated truck Ice bath and tubs <br /> Other (specify) <br />" i : xasL*' / <br />10. <br />Propano Tank ';T? <br />Jayna Casey—-Signature <br />LT II <br />~1 I <br />Soap and Water Rinse Water