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Environmental Health Department <br />10. <br />11. <br />OK <br />12. <br />1.1 Paper towels and pump-style soap container. <br />13. <br />•‘Important** <br />14. <br />5-20 Otil. <br />I *<ipor I Intwl lowols <br />Ice Cooler <br />I am providing the following for adequate hand washing facilities, hut separate from utensil wash within my <br />booth: <br />'^Writer supply dispenser with warm water at a minimum of 100°F (i.c. 5-20 gallon container with spigot). <br />| J Ono separate tub (bucket or basin) for the collection of rinso/wastowator. <br />5 Gill I hind wnsli <br />W.ir.towahu Gont.ilnnr <br />Gaibago <br />Can <br />SnnltUor buckot- <br />blo.-idi ft water for <br />•MorlilQ wiping cleiUin <br />Booth must bo on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />SANJOAOUIN <br />■ COUNTY <br />(ii col rirxi ornivs !»</<• <br />I am 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 41T temperature): <br />Q Ice chests ^Refrigerator <br />| J Refrigerated truck O Ice bath and tubs <br /> Other (specify)_ ____ ________________________________ <br />| Culliod (toard I <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 />X iwr Mikii <br />\ ]sjkjnature Title Date • <br />SlomovdClutfling <br />Dish <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />Three compartment sink. <br />O 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 />I.’] Detergent, bleach, and wiping cloths (cleaning towels). <br />I. I Tub to store wiping cloths In bleach solution. <br />| PiopiMM Innk <br />| I’liip.TO Slovn <br />18(581.. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464 0138 | www.sjcohd.com <br />1111)1602 Pn(|ft8nf1l ITMI’liVT-NTAPI' <br />0//.VI7 <br />. if.’j <br />I xh,> kc Ilans ft I <miI Cnnlolncts musl /k> ■ <br />sforerf (> Inclios oil ol ilia atotindl : <br />Nam^of ros^onsibje^py ojs to be present in booth during all hours of operation: <br />| I lealth Permit <br />Sonp nrwl Wator Ulnso Wator llloncli nml Wnlrir <br />Uro t xtintinlslior