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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 100T (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 />13. <br />••Important** <br />14. Completed by: "I <br />Health Permit <br />Paper Hand To«Mis <br />Soap dtipansar <br />BtoachPropane Stove <br />Propane Tank <br />Soap and Waler^7 <br />Faw ExtnauHhara <br />Page 8 of 11 <br />Scanned with CamScanner <br />Sleroo arfChaffrig <br />Ooh <br />5 Gal Hand wean <br />Waatawwer Corrtaerer <br />Garbage <br />Can <br />Sanmzer buckel- <br />Ueach & water for <br />atonng wiping doffis <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />Ice Cooler <br />Title <br />Water <br />I am providing the following items withinmy booth for the sanitary cleaning of food preparation utensil <br /> Three compartment sink. 1^ <br /> Three deep tubs (basins 6-3 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 />Etffa tea Bags < Food Containers must ba B <br />stored fl mcfias on o! the grourxP y <br />1868 E. Hazelton Avenue | Stockton. California 95205 | T 209 468-3420 | <br />ehD 16-02 Page 8 of 11 <br />07/3/1 r <br />—Booth must be on <br />Concrete. Asphalt. <br />Plywood, or a Tarp. <br />5-20 Gal <br />Hand wash Wstw <br />I Rinsa Waler ^—11 Bleach and Waler <br />NdHl^s^f responsible persons to be present in booth d^ng all hours^of operation: <br />g <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 />thfe ev^nt. <br />SAN JOAQUIN <br />-----COUNTY------ <br />GrCCfnrss yron< here. <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 j <br /> Other (specify) <br />F 209 464-0138 | www.sjcehd.com <br />TEMP EVENT APP