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Environmental Health Department <br />10. <br />i11. <br />OR <br />12. <br /> One separate tub (bucket or basin) for the collection of rinseAvastewater. <br />O Paper towels and pump-style soap container. <br />13. <br />evej <br />Completed by: 14. <br />Title DateSlgnatui <br />Health Permit <br />P«parHand <br />PrapanaStow <br />I <br />1 <br />Murtimd Water <br />Scanned with CamScanner <br />* Gal Hand aaati <br />Waaaawtear ConMnar <br />Sansxar bucftat- <br />teaacn t water tar <br />atomg wta*io ctama <br />£>•■ toa Bapa 4 Food Coneaawa muar Oa <br />afcaad 4 Pacnaa aft cfftt gmumU <br />All food vendor I <br />preparation for i <br />preparatoi and <br />Stemo WChaffinp <br />Oah <br />Garbage <br />Can <br />Booth must be on <br />Concrete. Asphalt <br />Plywood, or a Tarp. <br />5-20 Gal. <br />Hand amah Water <br />Proaana Tar* <br />“Important** <br />Soap daoanaar <br />-------aw a wwa % ■ <br />I SoapartWasr <br />L <br />z 7^ <br />Ice Cooler jmbmmbhhhhbhb <br />r <br />Rlnaa Water <br />ig the following items within my booth for the sanitary cleaning of food preparation utensil <br />tree compartment sink. <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 />O 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 />H^feter supply dispenser with warm water at a minimum of 100’F (i.e. 5-20 gallon container with spigot). <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 488-34201 F 209 464-0138 | www.sjcehd.com <br />EHD1M2 P^Ocfll TEMP EVENTAPP <br />07HA7 <br />SANJOAOUIN <br />-----COUNTY------ <br />C>-ectrcss grows here. <br />I am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br />45T Qf food is used the following day, maintain below 41 *F temperature): <br /> Im chests Refrigerator <br />Q^efrigerated truck Ice bath and tubs <br /> Other (specify)---------------------------------------------------------------------------------------------------------------------- <br />raths are subject to inspection. Please make a copy of this application in <br />ise^ent. A copy of this checklist must be in the booth at all hours of <br />tperafion^Rptdm original to festival coordinator three weeks prior to <br />| CaaniBofd | <br />Names of responsible persons to be present in booth during all hours of operation: