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Environmental Health Department <br />10. <br />11. <br />OR <br />for soapy water, one for rinsing and one for a bleach <br />12. <br />iter supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />13. <br />“Important** <br />14.Completed by. <br />DateSigi <br />Health Permit <br />Paper I land Tovral* <br />OleacnPropane Stove <br />05 <br />Propane Tank <br />Blotch and Water <br />Ice Cooler <br />i <br />i <br />i <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />Eitra Ice Begs « Food Containers must bo <br />stored 6 inches off or the ground! <br />Stenkj wrChaffmg <br />Dish <br />5 Gal Hand wash <br />Wastewater Container <br />Garbage <br />Can <br />Booth must be on <br />Concrete. Asphalt. <br />Plywood, ora Tarp. <br />San<aer bucket- <br />Moach 4 water tor <br />alonng wiping ctolhs <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />SAN JOAQUIN <br />( Extra \ <br />Water <br />Title <br />Soap disponsor <br />S^5ne separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Q^aper towels and pump-style soap container. <br />1868 k. Hazelton Avenue | Stockton. California 95205 | T 209 468-3420 1 F 209 464-0138 | www.Sjgov.org/ehd <br />EHO 16-02 Page 8 or 11 TEMP EVENT APP <br />06/19/19 <br />Rinse Waler <br />5-?O Gal <br />r- I land wash Water <br />]n\ <br />Pro Extinguisher <br />Names of responsible persons to be present in booth during all hours of operation: <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. R&iurn original to festival coordinator three weeks prior to <br />I amproviding the following items within my booth for the sanitary cleaning of food preparation utensil <br />S'lnree compartment sink. <br />B'fhree deep tubs (basins 6-8 inches minimum), one <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 />_z <br />So»p *nd Wator <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 />Sice chests Refrigerator <br />S'tfefrigerated truck Ice bath and tubs <br /> Other (specify)_____ __________________________ <br />I L <br />Culling Board