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FROM FAX NO.PS <br />11. <br />OR <br />12. <br />my <br />13. <br />*’Important** <br />14.Completed by: <br />Title <br />Health Permit <br />Pape< Hand TommqIs <br />5<XaC &pt5BCf <br />Cijiong Board <br />Propane Stove Blaaeh <br />1Propane Tank <br />EXtirc*Khcr <br />Sios&d 6 inches atfc^ tT» jjrtxrx? <br />8 of ii <br />Exira <br />W^nr <br />SaraixzBr hudeet- <br />Neaeti & water lor <br />Bioring wiping dome <br />0 Water 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 rinsa/wastewater. <br />Paper towels and pump-style soap container. <br />Stcmo WChSffiftg <br />Distfi <br />50^ Hand wotJi <br />W&8tenv3tBr Ccnta^xw <br />S30 Gal. <br />HvUwesh Water <br />Garbage <br />Can <br />rTMO. — ... , <br />Received Time Apr. 9. 2019 11:01PM No. 4908 <br />Environmental Health Department <br /> Booth must be on <br />Concrete, Asphalt, <br /> Plywood, or a Tarp. <br />Names of responsible persons to be present in booth during all hours of operation- <br />^OF/A w uebN _______ <br /> <br />| Soap and Watw water Qieacn and Water { <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 event <br /> ' (/ Signature Title Date <br />ww- <br />Ice Cooler"^I <br />________[X <br />45OF (if food is used the following day. maintain below 41 °F temperature): <br />IS Ice chests Refrigerator <br /> Refrigerated truck O^Ice bath and tubs <br />0 Other (specify) <br />Rmse Water <br />V"'*' < o on in* ten^Perature control for the cold holding of potentially hazardous foods below <br />ENVIRONMENTAL HEALTH <br />per.mit/services <br />larp providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />LJ Three compartment sink. <br />23 Three deep tubs (basins 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 />S Detergent, bleach, and wiping cloths (cleaning towels). <br />g] 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 <br />booth: <br />il. 24 2013 10:01PM <br />r®®® nA Haze,ton Avenue | Stockton, California 95205 ] T 209 468-3420 | F 209 464-0138 [ www.sjcehd.com <br />"3 8 11 TEMP EVENT APP <br />saiwoaouin <br />1:v,; J'—...COUN T Y------- <br />Greatness grows here. <br />10. I