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10. <br />12. <br />but separate from utensil wash within my <br />13. <br /> <br />Completed by: 14. <br />Signati <br />Paper Hand Towels <br />Soap dlspanser <br />Hra Extir.nulshcr <br />S’emow/Chafflng <br />Dish <br />5 Gal Hand wash <br />WasiswmCon’afoM <br />copy of this application in <br />"J at all hours of <br />— --------j prior to <br />San'Jizcrbucket- <br />feleach a waler for <br />storing wplno a'ofhs <br />Garbage <br />Can <br />5-20 Gal. <br />Hand weish wa:erHealth Permit p <br />Date <br />SAW JOAQOIW <br />COUNTY <br />Prapano Tank <br />Rinso Waler <br />f Extra A <br />I Waler <br />I <br />Catena Board <br />Propane Steve - <br />Soap and Water <br />i <br />E'Paper towels and pump-stylo soap container. <br />**lmportant** <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, ora Tarp. <br />supply dispenser with watm water at a minirnunl of 100T (j e 5.20 sa||on <br />^Bne separate tub (bucket or basin) for the collection of rinse/wastewater. <br />one for rinsing and one for a bleach <br />0 <br />Bleach and Water <br />^.Wfood9 is “XX* POtenfial,V ^rdous foods below <br />^^f,ests □Refrigerator <br />L^ethgerpted truck Ice bath and tubs <br />Ul Other (specify) <br />All food vendor booths are subject to inspection, <br />preparation for this event. ' <br />preparation and operation, <br />this events <br />E8iwronm©nta8 Deparimmf <br />—±—/\ <br />ice Cooler ■ i <br /> Three compartment sink. <br />□sS“r *- “»—■ <br />P^viding the following for adequate hand washing facilfe, <br />. Please make a c^y WI" UY <br />A copy of this checklist must be in the booth at a‘ii <br />ggjum original to festival coordinator three weeks <br />' Title <br />11- fcxss <br />OR ; - <br />Bleach <br />Bfra fja 3u§4 <8 Faad Containers must ba ?! <br />stored 6 Inches off of the ground! <br />^68 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | wmv.sjgov.org/ehd <br />nRHQMo Psge 8 cf 11 TEMPEVENTAPP