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10. <br />11. <br />OR <br />12. <br /> Water 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 /> Paper towels and pump-style soap container. <br />13.lames of i <br />Hr/5 <br />14. <br />Paper Hand Towels <br />Soap dispenser <br />Cutting Board <br />iBleachPropane Stove <br />0 <br />Propane Tank <br />Bleach and Water <br />Fire Extinguisher <br />Ice Cooler <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <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 />[X Ice chests Refrigerator <br /> Refrigerated truck Ice bath and tubs <br /> Other (specify) <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />0 Three compartment sink. <br />Extru lea Bags & Food Contsinors must bo <br />stored 6 Indios olfof the ground! <br />5 Sal Hand wash <br />Wasiovzalor Container <br />Garbage <br />Can <br />Sanitizer bucket­ <br />bleach i water for <br />storing wiping cloths <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, ora Tarp. <br />Stemo w/Chatting <br />Dish <br />5-20 Gal. <br />Hand wash Water <br />( Exda <br />Water <br />. . ... <br />Health Permit <br />Title <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. ,£2244^ <br />Date <br />Completed by: A <br />^Signature <br />Names of responsible persons to be present in b <br />Kr/ /<rn . Ka c I <br />Environmental Health Department <br />Important** <br />irsons to be present in booth during all hours of operation: <br />Rinse 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 />f I Tub to store wiping cloths In bleach solution. <br />cz <br />Soap and Water <br />SAN JOAOUIN <br />1863 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 [ •,vww.sjgov.org/ehd <br />EHD 16-02 Page 8 of 11 TEMP EVENT APP <br />06/19/19