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Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br />[/Grater 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 />[£pPaper towels and pump-style soap container. <br />13. <br />“Important** <br />14.Completed by: <br />1 Paper Hand Towels <br />Soap dispenser <br />BleachPropane Stove <br />05 <br />Propane Tank <br />4 <br />) <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utonsil <br />Three compartment sink. <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <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 />Q Detergent, bleach, and wiping cloths (cleaning towels). <br /> Tub to store wiping cloths in bleach solution. <br />Extra Ico Bags S Food Conlalnorx must bo <br />stored 6 Incbos off of tho ground! <br />Slorno w/Chnlfing <br />Dish <br />Extra <br />Wntor <br />6 Gnl Hand wash <br />V/astcwalor Contoinor <br />Garbage <br />Can <br />Snnlliznr buckot- <br />bloach & water lor <br />storing wiping dolhs <br />Booth must bo on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />I am providing the following cold temperature control for the cold holding of potentially hazardous foods bolow <br />45°F (if food is used the following day, maintain below 41°F temperature): <br />H Ice chests 2$ Refrigerator <br /> Refrigerated truck Ice bath and tubs <br /> Other (specify) <br />Signature <br />SAN JOAQUIN <br />COUN i Y <br />Title <br />Health Permit <br />Rinco Wnior <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420) F 209 464-0138 | www.sjgov.org/ehd <br />EHD 16-02 Page 8 of 11 TEMP EVENT APP <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 eyent. . <br /> <br />Date <br />15 <br />Soup and Water <br />5-20 Gal <br />5^ Hand wash Waler <br />Ico Cooler | <br />Names of responsible persons to be present in booth during all hours of operation: <br />________W\trAxcl\< nArkv-lnyw-V. -S - 7>l o - <br />j 1 lfC <br />Culling Board