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Environmental Health Department <br />10. <br />11.I ai <br />OR <br />12. <br />2TWater supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />13. <br />"Important** <br />PJ <br />14.Completed by: <br />Health Permit <br />Paper Hand Towels <br />Soap dispenser <br />Cutting Board <br />BleachPropane Stove <br />Propane Tank <br />Soap and Water Rinse Water Sleacti and Water <br />Fire Extinguisher <br />EHD 16-02 <br />07/3/17 <br />^'One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Paper 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 />p-providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />Three compartment sink. <br />Exira Ice Bogs A Food Containers must be <br />stored 6 Inches off ot the ground I <br />Stemow/Chafflng <br />Oah <br />Garbage <br />Can <br />Sonilizor buckot- <br />bloach& water for <br />storing wiping cloths <br />Booth must be on <br /> Concrete, Asphalt, <br />Plywood, or a Tarp. <br />S Gal Hand wash <br />Wastewater Container <br />5-20 Gal. <br />Hand wash Waler <br />Extra <br />Water <br />Title <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 />iration and operation. Return original to festival coordinator three weeks prior to <br />•‘ventll i ’ /" / <br /> W7/z6 <br />uaw <br />/■ <br />Vi <br /> Three deep tubs (basins 6-8 inches minimum), one for soapy v/ater, 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 />'ihf_ <br />[ Signature <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 <br />SAhbJOAOUIN <br />------COUNTY------ <br />Greetness grows here. <br />I am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br />45^ (if food is used the following day, maintain below 41°F temperature): <br /> Ice chests ^Refrigerator <br /> Refrigerated truck p. Ice bath and tubs v <br />Other (specify) I __ <br />Names of responsible persons to be present in booth during all hours of operation: <br />Ice Cooler