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Environmental Health Department <br />10. <br />12. <br />[jzLPaper towels and pump-style soap container. <br />13.Names of responsible persons to be present in booth during all hours of operation: <br />‘‘Important** <br />14.Completed by: <br />itifreSii <br />Health Permit <br />Paper Hand Towels <br />Soap dispenser <br />Cuttng Board <br />Propane Stove Bleach <br />Rlnso Wnlcr <br />Piro Extinguisher <br />Ice Cooler h <br />n Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />(71 One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Exira Ice Bags & Food Conlolncrs must be stored 6 Inches oil of lhe ground! <br />Stcmo w/ChaHing <br />Dish <br />Extra <br />Waler <br />5 Gal Hand wash <br />Wa stewater Container <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping cloths <br />5-20 Gal. <br />Hand wash Wator <br />Booth must bo on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />Propane Tank <br />....... ............................ k <br />—1 • •——A-———— ■ <br />Garbage <br />Can <br />Soap and Waler <br />LI 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 />f J Detergent, bleach, and wiping cloths (cleaning towels). <br /> Tub to store wiping cloths in bleach solution. <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />• J-S01 providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />Ln-Three compartment sink. <br />OR <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 operatjon. Return original to festival coordinator three weeks prior to <br />this event.y <br />-----?Sb TZo <br />Title Date <br />1868 E. Hazelton Avenue | Stockton, California 95205 I T 209 468-3420 1 F 209 464-0138 I wwwsicehdcom <br />S!?J76-02 Pageeofll TEMPEVENTAPP <br />UI / I / <br />/■'Ll sanjoaquin <br />' WLl • ------COUNTY------- <br />' Greotness yrows here. <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 /> Ice chests rf-Refrigerator <br /> Refrigerated truck Ice bath and tubs <br /> Other (specify)___ ________________________