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Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br />lZJ Paper towels and pump-style soap container <br />13. <br />‘’Important*’ <br />14.Completed by. <br />Title Date <br />Health Permit <br />Sos? <br />Stax-.* <br />I I <br />Prow <br />Hr.»e fuse <br />/ <br />P^ec<!t <br />FMr» '.* t Fa^ Ccrarxn -. u >» <br />tKV«d 6 inchBt a* lhe yra.nn-’ <br />EHD 16-0C <br />tyrnn? <br />0 Water supply dispenser with warm water at a minimum of 100cF (i.e 5-20 gallon container with spigot). <br /> One separate tub (bucket or basin) for the coHeciion of rinse/wastewater. <br />IM <br />E«JT» <br />5 Gftf Hrm W**tt <br />*40 Gal <br />«a«n <br />Garoage <br />Can <br />SwcwbuoM- <br />McMlft .retetar <br />aKKtn^ actti <br />Boon musi De on <br />Concrete. Aipha«. <br />Ptywcoc or s Tarp <br />Ice Cooler <br />SAN JOAQUIN <br />COUNTY — <br />Saa; <br />Names of responsible persons to be present m booth dunng all hours of operation: <br />Mike Mabutas & Denise Steml MlKo MafauIac ________________ <br /> Three deep tubs (basins 6-8 inches minimum), one for soapy water, one for nnsing and one for a bleach <br />solution (one tablespoon of bleach per gallon of water). <br />O Detergent bleach and wiping cloths (cleaning towels}. <br /> Tub to store wiping cloths in bleach solution. <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />0 Three compartment sink <br />I am providing the following tor adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />I am providing the following cold temperature control tor the cold holding of potentially hazardous foods below <br />45’F (if food is used the following day maintain below 41T temperature): <br /> Ice chests 0 Refrigerator <br /> Refrigerated truck tee bath and tubs <br />0 Other (specify) Refrigeration on mobile food facility <br />1866 E. Hazefton Avenue | Stockton California 952051 T 209 468-3420 1 F 209 464-0138 | wwwjstcend com <br />TCweveffAPP <br />All food vendor booths are subject to inspection. Please make a copy of this application in <br />preparation tor this event A copy of this checklist must be in the booth at aH hours of <br />preparation and operation. Return original to festival coordinator three weeks pripr to <br />this event. <br /> n Owner 05-09-2019 <br />I F*- <br />_ri