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Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br /> One separate tub (bucket or basin) for the collection of rinse/wastewater. <br /> Paper towels and pump-style soap container. <br />13. <br />“Important** <br />7 ?Completed by: 14. <br />Signature <br /> Paper Hand Towels <br />BleachPropane Stove <br />Propane Tank <br />Bleach and Water <br />Fire Extinguisher <br />____ <br />Ice Cooler <br />Rinse VJaler <br />Extra /co Bags & Food Contalnors must be <br />stored 6 inches oil of the groundl <br />Exira <br />Water <br />Sanitizer buckot- <br />bleach 4 wafer for <br />storing wiping cloths <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />[2fWater supply dispenser with warm water at a minimum of 100°F (l.e. 5-20 gallon container with spigot). <br />Slerno vz/Chaffing <br />Dish <br />5-20 Gal. <br />Hand wash Water <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />SAN JOAQUIN <br />------COUNTY------ <br />Health Permit [d <br />A0 <br />■ <>n?ntne>s <jtows herp. <br />I am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br />45OF (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 />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 /> L 'J. <br />DateTitle <br />-E <br />jL. <br />Sonp and Water <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 />Q'tub to store wiping cloths in bleach solution. <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 Page 6 of 11 TEMP EVENT APP <br />06/19/19 <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> Three compartment sink. <br />5 Gal Hand wash <br />Wastewater Conlainar <br />Names of responsible persons to be present in booth during all hours of operation: <br />zA . -J ~ <br />Garbage <br />Can <br />Soap dispenser