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Environment! Health Department <br />10. <br />12. <br />utensil wash within my <br />13. <br />'Important <br />Paper Hand Towels <br />Propane Stove <br />Rinse Water Bleach and Water <br />Fire Extlnpuisher <br />Ice Cooler i <br />nA Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 1 F 209 464-0138 I <br />Pape 8 of 11 1 <br />Extra Ice Bags & Food Containers must be <br />stored 6 inches off of the ground! <br />5-20 Gal. <br />Hand wash Water <br />Sanitizer buclcet- <br />bleach & water for <br />storing wiping cloths <br />Stemo w/Chaffing <br />Dish <br />Garbage <br />Can <br />5 Gal Hand wash <br />Wastewater Container <br />www.sjgov.org/ehd <br />TCUP PVCIdT ADO <br />SAN JOAQUIN <br />-----COUNTY <br />Water <br />Title <br />I Propane Tank <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />____/ <br />LZ’ce chests Q^efrigerator <br /> Refrigerated truck |ce bath and tubs <br /> Other (specify) <br />Names ofresponsible persons to be present in booth during all hours of operation: <br />-----------A.&ujl ____________________ <br />,------------------ <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 />14. Completed by: <br />Signature <br />T~ <br />Soap and Water I <br />Soap dispenser I ,. <br />Bleach s. <br />hn^Pr°Vidin9 1116 fo,,owin9 for adequate hand washing facilities, but separate from <br />Doom. <br />IZWater supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />D'One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Draper towels and pump-style soap container. <br />11' my b00th for the sanitary cleanin9 Preparation utensil <br />OR <br /> Detergent, bleach, and wiping cloths (cleaning towels). <br />U Tub to store wiping cloths in bleach solution.