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Environmental Health Department <br />10. <br />I arryyfl^iding the following items within my booth for the sanitary cleaning of food preparation utensil <br />Sihree compartment sink. <br />11. <br />OR <br />12. <br /> . .dter supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />13. <br />“Important** <br />Completed by: 14. <br />Signature <br />.1Health Permit <br />it <br />PfCp*r*o Tank <br />Ice Cooler <br />TEMP EVENT APP <br />...ice 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 /> Tub to store wiping cloths in bleach solution. <br />j•• <br />Elin IctBigiiFood Conltinen mull ba <br />uovd 6 (JI iJ Un g/uurtli <br />b Gal >Ikij nai-i <br />Wailcw Jlar ConU n«r <br />Garbage <br />Can <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 />’ests Refrigerator <br />0'tfefngerated truck <br /> Other (specify) <br />Slemo v/Ourms <br />am <br />SanMarbucM- <br />btadi I walar for <br />•■.oring wping dochi <br />Booth must be on <br />Concrete. Asphalt, <br />Plywood, or a Tarp- <br />SAN JOAQUIN <br />COUNT Y— <br />_.ic,separate tub (bucket or basin) for the collection of rinse/waslewater. <br />.j^r towels and pump-style soap container. <br />Title <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjcehd.com <br />EHO 16-02 Pn0" 8 ol 11 TZit" r.TJ.’T <br />07/3/17 <br />XX RkueWtUr <br />rz <br />Sup and Wiler <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 /> 2.3 <br />Date <br />5-20 Gil <br />r- Hind wl«l Wtaw <br />Soapatnontlr ---------A <br /> “M <br />! | tUichind Wi'xi I <br />® f <br />Names of responsible persons to be present in booth during all houra of opMation: <br />_________qc rencr'