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Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br />13 Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />03 One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />0 Paper towels and pump-style soap container. <br />13. <br />^Important** <br />14.Completed by: <br />Signature <br />Paper Hand fowls <br />Soap dispenser <br />Cutting Hoard <br />HleachPropane Stove <br />0itit0 <br />Propane f ank <br />Bleach and WaterRinse Water <br />I ire Extinguisher <br />Ice Cooler <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 <br />Water <br />5 Gal I land wash <br />Wastewater Container <br />Garbage <br />Can <br />Sanitizer bucket <br />bleach 8. water tor <br />storing wiping cloths <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 />M Ice chests J2 Refrigerator <br /> Refrigerated truck Ice bath and tubs <br />S'Other (specify)_ <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 />0 Detergent, bleach, and wiping cloths (cleaning towels). <br />I^Tub to store wiping cloths in bleach solution. <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />Sterno wfChalfing <br />Dish <br />SAN JOAQUIN <br />C '..■Ulf ■ ■ <br />Title <br />... . . ;, • ■ <br />/ce Bags 8. Foot! Conlaincts must be <br />stated 6 inches off oT ffie giound' <br />1868 E. Hazelton Avenue | Stockton. California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />EHD 16-02 Page 8 o( 11 TEMP EVENT APP <br />07/01/2024 <br />/ <br />Soap and Walci <br />1---------;-----------1: <br />Health Permit <br />5 20 Gal <br />I land wash Waler <br />Date <br />Names of responsible persons to be present in booth during all hours of operation: <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