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Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br />Paper towels and pump-style soap container. <br />13. <br />**lm portant** <br />14.Completed by: <br />Health Permit <br />Paper Hand Towels <br />Soap dispenser <br />Cutlinq Board <br />BleachPropane Stove <br />Di <br />Fire Extinguisher <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 /> Detergent, bleach, and wiping cloths (cleaning towels). <br /> Tub to store wiping cloths in bleach solution. <br />Stemo wrChaffing <br />Dish <br />5 Gol Hand wash <br />Wastewater Container <br />Garbage <br />Can <br />Sanitizer bucket­ <br />bleach a water lor <br />storr.g wiping cloths <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />^Iwater supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />^One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />0Three compartment sink. <br />Extra <br />Water <br />SAN JOAQUIN <br />------COUNTY <br />-r* (__2 <br />Soap and Water <br />/ <br />Rinse Water <br />Booth must be on <br />Concrete, Asphalt. <br />Plywood, or a Tarp, k____ ______ <br />Propane Tank ---------------> <br />5-20 Gaf. <br />Hard wash Water <br />Ice Cooler <br />I am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br />AST (if food is used the following day, maintain below 41T temperature): <br />^C^e chests J^T^efrigerator <br />^rT^efrigerated truck 1-T Ice bath and tubs <br /> Other (specify) <br />mbooth during all hours of operation: <br />..._' i a copy of this application in <br />A copy of this checklist must be in the booth at all hours of <br />ation and ooeratioru Return ^original to festival coordinator three weeks prior _to <br />lb-^-2^ <br />&gnahjrtr^ Title Date <br />stored 6 nches olfollht groundl L <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420) F 209 464-0138 | www.sjgov.org/ehd <br />EHD 16-02 Page 6 of 11 TEMP EVENT APP <br />06/29/2023 <br />0 LzJL <br />Names of responsible persons to be present <br />v I <br />All food vendor booths are subject to inspection. Please make <br />preparation for this event, <br />preparation and operation <br />this evi