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■ z <br />Environmental Health Department <br />OR <br /> 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 rinse/wastewater. <br /> Paper towels and pump-style soap container. <br />© Names of responsible persons to be present in booth during all hours of operation: <br />Important' <br />14.Completed by: <br />Date <br />Paper Hand Towels <br />Soap d.spenser <br />Cutting Board A BleachPropane Stove <br />0 <br />Propane Tank <br />2 Bleach and Water <br />Fire Extinguisher <br />Ice Cooler <br />EHD 16-02 <br />07/01/2024 <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: <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 O Ice bath and tubs <br /> Other (specify) <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 />Extra <br />Waler <br />Garbage <br />Can <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> Three compartment sink. <br />Slcrno vn'CFattingDisb <br />5 Gal Hand wash <br />Wastewater Container <br />5 20 Gal <br />Hand wash Water <br />Sanitizer bucket­ <br />bleach 4 water tor <br />storing wiping cloths <br />SAN JOAQUIN <br />COUNTY <br />_ <br />5-6-^ <br />Title <br />_________ <br />Health Permit <br />Rinse Water <br />___________________ <br />Extra Ice Bags 4 Food Containers must be <br />stored 6 inches oflol the ground! <br />Soap and Water <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />~ :c 1C 22 Page 8 of 11 TEMP EVENT APP <br />mature Q