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0 0003/000304/16/2019 8:10 AM FAX <br />s <br />Environmental Health Department <br />11. <br />OR <br />12. <br />'aper towels and pump-style spgB container. <br />13. <br />**lmportant** <br />14.Completed by: <br />Date <br />Health Permit <br />Papcf Hart T<»»el» <br />S&ap d>;pons«r <br />Cuflkg Soirt <br />BlcaihPfDfwnB Btavo <br />Pmpan»Tan>< <br />Ffre SdingixtHsr <br />Ice Cooler - <br />Received Time A p r. 16. 2019 9:06AM No. 4935 <br />Jroviding the following items within my booth for the sanitary cleaning of food preparation utensil <br />iree compartment sink. <br />airs Sass a Food Co^Mners musi bo <br />fJorad 6 tuditis oMo/ltM gmor.cl <br />Sle'no w/CbaHing <br />D«i <br />5 Gal Hnl WOSD <br />Waalewatw CortUlrwr <br />6-20 <br />HsnfiwsaJi Waler <br /> Booth must be on <br />Concrete, Asphalt. <br />Plywood, or a Tarp. <br />MANJOAQUIN <br />------COUNTY------- <br />Grsotness grows here. <br />I am providing the fallowing coW temperature control for the cold holding of potentially hazardous foods below <br />45aF (if food is used We following day, maintain below 41 °F temperature): <br />Q loo chests ^Refrigerator <br /> Refrigerated truck Ice bath and tubs <br /> Other (specify)^ <br />ion; <br />SartizisrbbtKeJ- <br />Wrodi S water fC <br />itorwg wiring cloths <br />I am providing the following for adequate hand washing facilities, hut separate from utensil wash within my <br />booth: <br />^Qlrt/ater supply dispenser with warm water at a minimum of lOO’F (i.e. 5-20 gallon container with spigot). <br />j^Sf^naseparate tub (bucket or basin) for the collection of rinse/wastewater. <br />f EMTE \ <br />I V/nln <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 orioinel to festival coordinator three weeks prior to <br />Signature Title <br />HJ <br />v"'-. ' <br />1868 £ Hazelton Avenue | Stockton, California 95205 ] T 209 468-3420 | F 209 464-0138 | www.sjcehd.com <br />EHD IB-02 Page 0 of 11 TEMP EVENT APP <br />07/3/17 <br />|c <br />10. <br /> Three deep tubs (basins 6-8 inchas 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 /> Tub to store wiping cloths in bleach solution. <br />Soap and Water RlnscWaftn <br />Names of responsible persons to be present Iribooth during all hours of oj <br />r*’ <br />Garbage <br />Can <br />Bleach and Waler