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Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br /> Water supply dispenser with warm water at a minimum of 100oF (i.e. 5-20 gallon container with spigot). <br />13. <br />14. <br />Health Permit <br />Paper Hand Towola <br />Soap diapoMer <br />BleachPropane Stove <br />Propane Tank <br />Rinao Water <br />Piro Ejitinnuiahor <br />Ice Cooler <br />[ <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> Three compartment sink. <br />Stoeno wfChaffing <br />Duh <br />Kxva <br />Water <br />6 Gal Hand waih <br />Wastewater Container <br />Garbage <br />Can <br />Booth must bo on <br />Concrote. Asphalt. <br />Plywood, or a Tarp. <br /> One separate tub (bucket or basin) for the collection of rlnse/wastewater. <br />S Paper towels and pump-style soap container. <br />6.20 Oal <br />Hand wash Water <br />SAN JOAQUIN <br />-----COUNTY------ <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 />Quetergent, bleach, and wiping cloths (cleaning towels). <br /> Tub to store wiping cloths In bleach solution. <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 />0lce chests Refrigerator <br /> Refrigerated truck Ice bath and tubs <br /> Other (specify)__ <br />ignature <br />___L <br />Soap and Watar <br />**lmportant** <br />Names of responsible persons to be present in booth during all hours of operation: <br />(co Haga A >-<yxi Contamort mutt ba <br />itorad B mchos off o! Iho ground' ' <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 />Completed bI <<: . .. <br />Signature Title Date <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />EHD 1 a-02 Page fl of 11 TEMP EVENT APP <br />06/10/10 <br />3 U 0 LxJ <br />Samuier bucket, <br />bloacti A wutor lot <br />r utoring wiping cloth* <br />i f <br />Cutting Boara