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Environmental Health Department <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil11. <br />X Three compartment sink. <br />OR <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my booth:12. <br />X 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 />X Paper towels and pump-style soap container. <br />13. <br />14.Completed by: <br />:ure <br />Paper Hand Towels <br />Soap dispenser <br />Cutting Board <br />Propane Stove <br />Bleach <br />Propane Tank Fire Extinguisher <br />Soap and Water Rinse Water Bleach and Water <br />Three deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach solution <br />(one tablespoon of bleach per gallon of water). <br />X Detergent, bleach, and wiping cloths (cleaning towels). <br />Tub to store wiping cloths in bleach solution. <br />Refrigerated truck <br />Other (specify) <br />Stemo w/Chaffing <br />Dish <br />Garbage <br />Can <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping cloths <br />w.org/ehd <br />UP EVENT APP <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />5-20 Gal. <br />Hand wash Water <br />Names of responsible persons to be present in booth during all hours of operation: <br />STELLA & JERROD LAKEY <br />OWNER <br />Title <br />tWh E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F ztnr-ro^-Olt <br />EHD 16-02 Page 8 of 13 <br />06/19/19 <br />10. <br />7/10/23 <br />Date <br />** Im porta nt** <br />Ice Cooler <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 evept. <br />MN IOAOUIN <br />-------COUNTY------- <br />Greatness grows 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 />X Ice chests X Refrigerator <br />Ice bath and tubs