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Environmental Health Department <br />11. <br />OR <br />12. <br />Q 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 Towels <br />JCutang Board <br />Prnpana Stove <br />PropaneTank <br />□teach end Water <br />Ice Cooler <br />Health Permit <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. <br />5 Gal Hand wash <br />Wastnwater Gcntainer <br />Garbage <br />Can <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp- <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />5-20 Gal. <br />Hand wash Water <br />Sanliizerliuckei- <br />Keach & waler Ice <br />storing wiping doths <br />Stemo w/Chatfing <br />Osh <br />Bleach <br />Extm Ice Bags 4 Food Containe.'s rnusl bo <br />stored 6 Inches cat otthe ground! <br />Title <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 />EQ Detergent, bleach, and wiping cloths (cleaning towels). <br />0 Tub to store wiping cloths in bleach solution. <br />/ - <br />Rinso Water <br />lam providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />Jy Three compartment sink. <br />2U <br />■T’.-".: -■» —f i <br />SB’ <br />L <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 f F 209 464-0138 | www.sjcehd.com <br />EHD 164)2 Page 8 of 11 TEMP EVENT APP <br />07/3/17 <br /> Soap dtspanser I <br />^BSANJOAQUIN <br />C • B J'V ■" > ------COUNT Y— <br />Greatness grows here. <br />10. lam 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 />■gj Ice chests ^Refrigerator <br /> Refrigerated truck Ice bath and tubs <br />^Other (specify). <br />Mt—ISIlM , U t U Ql <br />Soap and Water <br />7^-7-^-2-^ <br />Date <br />Fire Extinguisher <br />Names of responsible persons to be present in booth during all hours of operation: <br />TZZ-tfA <br />Extra <br />Water