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Environments! Health Department <br />10. <br />■XJk 11. <br />OR <br />Water supply dispenser with warm water al 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 />□ Paper towels and pump-style soap container. <br />13. <br />Completed by:14. <br />£ <br />Paper Hand Townts <br />CuWng Board <br />Propane Stove <br />a <br />PJrarti and Water <br />Fee EjOnOteSlrw <br />Health Permit <br />EHD 16-02 <br />06/19/19 <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />Stems wrOssdfcv <br />Doh <br />Booth must be on <br />Concrete. Asphalt. <br />Plywood, or a Tarp. <br />S Gal Hand wash <br />Gai <br />Hard azasn V.-utat <br />Garbage <br />Can <br />Ice Cooler ' j <br />__________>' <br />SanSief b-.-cAeS <br />t£±bcf> & bi <br />stonng tuping dolhs <br />SANJOAQUIN <br />— coun-v <br />G-c,' <br />0 <br />Title Date <br />Names of responsible persons to be present in booth during all hours of operation: <br />tC’.A'^S'O <br />‘•Important** <br />I <br />Scap ted Water Rxx»ate« <br />Propane Tank <br />EUnlcaB^tFaoaCMatummuabe ? <br />ttored e Mm an at thu gnMnd! i <br />1 am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />□ Three compartment sink. <br />Q 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 />O Detergent, bleach, and wiping cloths (cleaning towels). <br />□ Tub to store wiping cloths in bleach solution. <br />VG <-•?>•■ c \ > \ \ o_____________________________________________________________ <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 />:_________V) 0 <br />Signature <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | wvAv.sjgov.org/ehd <br />Cun *" "** Pago 8 oil 1 TEMP EVENT APP <br />’ r • k - <» <br />1 •the fo,lowin9 601(1 temperature control for the cold holding of potentially hazardous foods below <br />4b F (it food is used the following day, maintain below4IT temperature): <br />® 1ce chests [J Refrigerator <br />® Refrigerated truck f~) foe bath and tubs <br />@ Other (specify)______________________________ ___________________________________