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Environmental Health Department <br />lanj^roviding the following items within my booth for the sanitary cleaning of food preparation utensil <br />H'Three compartment sink. <br />11. <br />OR <br />12. <br />F'f'VVater 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 />Health Permit <br />Paper Hand Towels <br />Soap dispenser <br />Culling Board <br />BleachPropane Stove <br />.'I <br />Rinse Water Bleach end Waler <br />Piro Extinguisher <br />EHD 16-02 <br />07/3/17 <br /> One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />[^fpaper 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 />Sterno w/Chaffing <br />Dish <br />Extra <br />Water <br />5 Gal Hand wash <br />Wastewaler Container <br />Garbage <br />Can <br />Sanitizer bucket­ <br />bleach 6 water for <br />storing wiping cloths <br /> Booth must be on <br />Concrete. Asphalt, <br />Plywood, or a Tarp. <br />Title <br />Ex/ra Ice [Jags & rood Conlalncis must bo <br />stored 6 inches ottofthe gioundl <br />Soap and Water <br /> Three deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br />solytlbn (one tablespoon of bleach per gallon of water). <br />PHpetergent, bleach, and wiping cloths (cleaning towels). <br />01 ub to store wiping cloths in bleach solution. <br />Z T <br />Ice Cooler << <br />______F <br />5-20 Gal. <br />I land wash Waler <br />Propane Tank <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 />preparationxand operation. Return original to festival coordinator three weeks prior to <br />this evonty ///' 7 ~/ <br /> <br />signature Title Date/ <br />S AN JOAQUIN <br />------COUNTY------• <br />Greotness grov/$ here. <br />10. lam 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 0Refrigerator <br /> Refrigerated truck Ice bath and tubs <br /> Other (specify)___ ______________ <br />Names of responsible persons to be present in booth during all hours of operation: <br /> —— j <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjcehd.com <br />Pago 8 of 11 TEMP EVENT APP