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Environmental Health Department <br />10. <br />11. <br />OR <br />12 <br /> Paper towels and punip-style soap container <br />13 <br />“Important" <br />14.Competed by <br />Papwr Haro <br />Ice Cooler <br />209 464-0138 | www sjgov_oro/ehd_ <br />Title <br />K Water supply dispenser with warm water at a minimum of 100°F (t.e. 5-20 gaflon containe«- -with spigot <br />Q One separate tub (bucket or basin) for the co'lection of hnss/wastewater <br />Garbaoe <br />Can <br />I am orovlding the following for adequate hand washing facilities out separate from utensil wash within my <br />booth: <br />SGaHMwMf. <br />WatMoM Ca-Mw <br />g <br />g <br />c <br />s ho <br />s <br />ID <br />hJ <br />0= <br />n5 tn <br />GJ <br />co <br />XI <:SAN JOAQUIN <br />COUN’v <br />I WumT <br />3 <br />3 ai <br />a o <br />o <br />n> <br />b o <br />3 <br />3 <br />(U <br />c <br />GJ <br />£ rc <br />01 <br />3 =r <br />a? o I <br />x g <br />in <br />t'j s <br />—k <br />3? <br />o <br />3 <br />b o <br />3 <br />O <br />2. x <br />3 <br />3 <br />Nx <br />a w <br />CD <br />3 s <br />"0 o z <br />N <br />CD <br />X <br />CD <br />3 <br />o <br />3 <br />n <br />J-X GM <br />r- HMwtl'WUv <br />Return original to festival coordinator three weeks prior to <br /> ^/Z-l / Z-^ <br />Date <br />I am providing the following items within my booth for I ho sanitary cleaning of food preparatnr utensi <br />"Fhree compartment sink <br />O Three deep tubs (basins 6-5 inches minimum), one for soapy water, one for r-nsmg and ora for a oieacr <br />soludor (one tablespoon of bleach par gallon of water) <br />L_ Detergent, bleach, ano wiping cloths (cleaning towels) <br /> Tub to store wiping cloths in bleach solution. <br />\ / \ a»«iMrax«» i <br />I \ / \ ie aci»-^OK <br />i c—2^ / r I %*yv^ ***** i <br />'' CiiO <br />V/MfaW <br />I am providing the following cold lernpwatum control fm the cold hokiinq of pornr-traiby nar^'dous 'oods ceiow <br />45‘F (If food is used the following day maintain below 41T temperalure) <br /> tee chests Refrigerntnr <br />K Refrigerated truck Cl Ice hath and It ibn <br /> Other (specify) <br />Names of responsible persons to be present In booth during all hours of operation <br />r>CA< C C CcA ■~ri tX. C <■ v-><Ur < <,<~iTa ------- <br />All food vendor booths are subject to Inspection Ploase make a copy of this application n <br />preparation for this event. A copy of this checklist must be In the booth at all hours of <br />preparation and operation. IWM, .. <br />this event. <br />'Signature <br />Htne entfloi a* or s» (W* <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F <br />EHOiwn p—a.ru <br />Health Permit