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/0 <br />* <br />Environmental Health Department <br />10. <br />I ai11. <br />OR <br />I <br />12. <br />13. <br />Completed by:14. <br />:ure <br />Health Permit <br />Paper Hand Towels <br />Soap dispenser <br />Cutting Board <br />BleachPropane Stove <br />Fire Extinguisher <br />TEMP EVENT APP <br />Uff 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 />^providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />hree compartment sink. <br />Extra tee Bags & Food Containers must be <br />stored 6 mbes off of the groorfi! <br />i- ’ <br />Garbage <br />Can <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />Stems wtChaffing <br />Dish <br />Extra <br />Water <br />5 Gal Hand wash <br />Wastewater Could ii kji <br />5-20 Gai. <br />Hand wash Water <br />Sanilizer bucket* <br />tdcach & water for <br />storing wiping doths <br />Title <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />s/water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />Sfone separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Q^Paper towels and pump-style soap container. <br />Propane Tank <br />NameSrOf responsible persons to be present in booth during all hours of operation: <br />Important <br />li <br />Ice Cooler ■ <br />-A SAN JOAOUIN <br />.. . -------COUNTY—* <br />/ Grectness nra;?? -ie.'S. <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 41°F temperature): <br /> ice chests □Refrigerator <br /> Refrigerated truck Ice bath and tubs <br /> Other (specify) <br />Date <br />d <br />1868 E. Hazelton Avenue I Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />EHD 16-02 PageBofll TEMPEVENT A! <br />06/29/2023 <br />nt** 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 />SffliSQBSaL_LL—U—, <br />Soap and Water TOnse Water