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Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br />O Paper towels and pump-style soap container. <br />13. <br />“Important** <br />Completed by: 14. <br />Health Permit <br />Popor Hand Tow«h <br />Cultinn Ooanl 3 < <br />lllejiliPropano Stove <br />3:LX JL J <br />Ptopano lank <br />lltondi and Water <br />FliO Lklinquilhcr <br />Ice Cooler <br />TEMP EVENT AF’P <br />J <br />ExlM <br />Water <br />5 Gal Hand wash <br />V/aslo-.valnr Container <br />Garbage <br />Can <br />Booth must be on <br />Concrete, Asphalt. <br />Plywood, or a Tarp. <br />|JQ Water supply dispenser with warm water at a minimum of 1 GOT (i.o. 5-20 gallon container with spigot). <br /> One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />l:tl/o lea Hngt A rood Cor.toineis mosl bn <br />stored 6 Indios otf nt the ground.' <br />5-20 Gal <br />Hand wash Water <br />Snnddor buckel- <br />Ideach A wnlcr lor <br />stating wiping cloths <br />Slotno w/Challing <br />Dish <br />SAN JOAQUIN <br />■_. OU : i I v <br />Names of responsible persons to be present in booth during all hours of operation: <br />7/ /4i-t/f&f'Z'________________________ <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />EHD 16-02 PaguBofll TE.“P EVENT A! <br />06/19/19 <br />_z <br />Hinso VMtnr <br />L_L <br />Soap nnd Wnlcr <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 Refrigerator <br /> Refrigerated truck / /□ Ice bath and tubs <br />I^Other (specify)-— <br /> | Soap dispenser <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 /> <br />- y- 'signature Title Date <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />f^j Three compartment sink. <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 />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: