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Environmental Health Department <br />w. <br />11. <br />OR <br />12. <br />13. <br />“Important** <br />Completed by: 14. <br />Health Permit <br />Pap«r Hand Towels <br />Soao dispenser <br />Ctf.tng Beard 1 BleachPropane Stove <br />0u <br />Prooane T ank <br />Blea^t and Water <br />Are Extinguisher <br />Ice Cooler <br />!un^;HaZellOn Avenue | Stockton, California 95205 | T 209 468-3420 1 F 209 464-0138 I <br />I <br />I <br />Tl <br />/ <br />Rinse Waler Garbage <br />Can <br />Sanitizer bucket* <br />Ueach & water tor <br />storing wiping doths <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />Stemo w/Chaffug <br />Osh <br />5 Gal Hand wash <br />Wastewater Container <br />5-20 Gal. <br />Hand wash Water <br />www.sjgov.org/ehd <br />TEMP EVENT APP <br />;.SANJOAOUIN <br />------COUNTY------- <br />Greatness grows here. <br />providing the following cold temperature control for the cold holding of potentially hazardous foods below <br />( Exira \ <br />Water I <br />............................i■■ <br />£«!ra Ice Bags 4 Food Containers must be <br />stored 6 inches ott of the ground' <br />_z <br />Soap and Water <br />12. <br />Date <br />.’f ifv <br />I am ,----------- . <br />45°F (if food is used the following day, maintain below 41 °F temperature): <br />E Ice chests Refrigerator <br /> Refrigerated truck Ice bath and tubs <br /> Other (specify) <br />r[ <br />nt in booth during all hours of operation: <br />/ ________________ <br />Names of responsible persons to be present in <br />_____/a Q / <br />All food vendor booths areZubject 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 />Signature <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> Three compartment sink. <br /> Three deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing anyone for a bleach <br />solution (one tablespoon of bleach per gallon of water). / /. . isd?? <br /> Detergent, bleach, and wiping cloths (cleaning towels). // <br /> Tub to store wiping cloths in bleach solution. Q <br />I am providing the following for adequate hand washing facilities, out separate from utensil wash within my <br />booth: <br />Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />[1/One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Paper towels and pump-style soap container. <br />Z I . ■■