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Environmental Health Department <br />1ML <br />11. <br />OR <br />12. <br />I^Wator supply dispenser with warm water at a minimum of 100°F (l.e. 5-20 gallon container with spigot). <br />13. Names of responsible persons to be present in booth during all hours of operation: <br />rticJiKd <br />•‘Important** <br />14. <br />Date <br />Health Permit <br />PaporHind Towola <br />Piopsno Slovo <br />f'ropano Tank <br />Blonch end Water <br />]Fira Bxllnnulihor <br />_ , I <br />Ice Cooler i <br />fl <br />Q One separate tub (bucket or basin) for the collection of rlnse/wastewater. <br />$3 Paper towels and pump-style soap container. <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />6 Oil HsndWMh <br />Weitowntor Container <br />6-20 Gal. <br />Hend waih Wolor <br />Garbage <br />Can <br />Senlllior buckol- <br />bloach * wntor for <br />noting vdplng clolhi <br />Booth must bo on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />SAN JOAQUIN <br />COUNIY <br />f Exlro \ <br />Water <br />A? tA <br />Title <br />Exira let O»at i Food Conlalnort mult bo <br />slondG Indios ottollho ground! <br />L <br />Soap end Waior Rinse Water <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 />. Completed by: (\9a am'&l(ol^l <br />' - Signature <br />Health Permit •’ ----------------------------------------------------- Slomo w/Chaffing <br />Dish <br />I am providing the following Items within my booth for the sanitary cleaning of food preparation utensil <br />®Throe compartment sink, /aj K <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 /> Tub to store wiping cloths In bleach solution. <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420) F 209 464-0138 | www.sjgov.org/ohd <br />EKO 10 02 Pago 0 of 11 TEMP EVENT APP <br />06/19/19 <br />8o»p dtaponior ---------- <br />lllooch <br />BO <br />10. lam providing the following cold temperature control for the cold holding of potentially hazardous foods below <br />45OF (if food Is used the following day, maintain below 41°F temperature): <br />(j&lce chests Refrigerator <br /> Refrigerated truck Ice bath and tubs <br />E2 Other (specify) /a/4 I ia eJr fir tape