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Environmental Health Department <br />10. <br />11.temS Wthin my b00,h f°r *he Sanitary Cleaning of f00d preParation utensil <br />OR <br />12. <br />utensil wash within my <br />13. <br />14.Completed by: <br />Health Permit U <br />Paper Hand Towels <br />Soap dispenser <br />Cutting Board <br />Propane Slove Bleach <br />IPrepane Tank <br />Rinse Waler <br />J <br />Page 8 of 11 <br />Exira lea Bags t> Food Containers must be <br />stored 6 inches off of the ground! <br />Stemo w/Chaffing <br />Dish <br />Garbage <br />Can <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, ora Tarp. <br />Date/ <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping cloths <br />5 Gal Hand wash <br />Wastewater Container <br />SAN JOAOUIN <br />COUNTY <br />f Extra \ <br />Waler <br />_z <br />Soap and Water <br />ehd HaZe"°n AVenUe 1 Stockton' California 95205 | T 209 468-3420, F 209 464-0138 | www.sjgov.org/ehd <br />07/01/2024 Page 8 °f 11 TEMP EVENT APP <br />s ,or soapy wa,er'one for rinsing and one f°r a bieachEJ Detergent, bleach, and wiping cloths (cleaning towels). <br />U Tub to store wiping cloths in bleach solution. <br />' •the “9.?°,d 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): nazaraous roods below <br />® Io® chests Refrigerator <br />Q Refrigerated truck Q] Ice bath and tubs <br />□ Other (specify)_______ <br />5-20 Gal. <br />Hand wash Water <br />“,mPortant 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 /> Slg^ture Title <br />Fire Extinguisher: m ---- <br /><----------f <br />Ice Cooler ' <br />3U0 <br />Bleach and Water | <br />booth^0^'09 1116 f°ll0Win9 for adecluate hand washing facilities, but separate from <br />Water supply dispenser with warm water at a minimum of 100T (i.e. 5-20 gallon container with spigot). <br />□ One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Isjl Paper towels and pump-style soap container. <br />Names of responsible persons to be present in booth during all hours of operation’ <br />(YUf.VxHU '