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Environmental Health Department <br />12. <br />'aper towels and pump-style soap container. <br />13. <br />^Important** <br />14.Completed by: <br />Signature Title Date <br />PnpcrHand Towels <br />Soap dispenser <br />Culling Board <br />Propane Stovo Bleach <br />Propane Tank <br />Piro Extinguisher <br />Garbage <br />Can <br />Sanilizer buckct- <br />bleacli & water for <br />storing wiping cloths <br />Booth must bo on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />Stcmo w/Chaffing <br />Dish <br />S-2O Gal. <br />Hand wash Water <br />Extra <br />Water <br />5 Gal Hand wash ' <br />Wastewater ContainerExira Ico flags & Food Containers must be <br />stored 6 Indios oil of the ground! <br />t <br />Soap and Water <br />SANJOAOUIN <br />------COUNTY------- <br />Greotness grows here. <br />10. <br />Ice Cooler $ <br />_____F <br />1' <br />2- ; -V-) \ \ <br />Rinso Waler Bleach and 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 />this event. <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />^01/Vater 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 />Names of responsible persons to be present in booth during all hours of operation: <br />___<? r J 'Trx __________________________ <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 />O Ice chests Refrigerator <br />O,Refrigerated truck Ice bath and tubs <br />JZ] Other (specify) 'Prezexy ,‘Ice. (Lt-eo/A <br />11. I an> providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />Jzi Three compartment sink. <br />OR ’ <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 />run ?rE- Hazelton Avenue | Stockton, California 95205 | T 209 468-3420) F 209 464-0138 | www.sjcehd.com <br />07/3/17 02 Pa0° 0 of 11 TEMP EVENT APP <br />P'Tfoalt^e^m^'^