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Environmental Health Department <br />11. <br />OR <br />12. <br />13. <br />14. <br />Health Permit <br />Paper Hand Towels <br />Soap dispenser <br />Propane Tank <br />Soap and Water Rinse Water Bleach and Water <br />Fire Extinguisher <br />Page 8 of 11 <br />Extra <br />Water <br />Stemo w/Chaffing <br />Dish <br />5 Gal Hand wash <br />Waste water Container <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping doths <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />10. <br />Extra Ice Bags & Food Containers must be <br />stored 6 inches off of the ground! <br />5-20 Gd. <br />Hand wash Water <br />Garbage <br />Can <br />Cutting Board <br />Propane Stove -I Bleach <br />ehd ?M2 Hazelton Avenue 1 Stockton, California 95205 | T 209 468-3420] F 209 464-0138 | www.sjcehd.com <br />07/3/17 Pa9e 8 °f 11 TEMP EVENT APP <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 />//his event. , y ' ----- <br />Completed DfLft- fa <br />' signature' Title Date <br />boothPr°Vidin9 the followin9 for adequate hand washing facilities, but separate from utensil wash within my <br />l^^ater supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />^P*bne separate tub (bucket or basin) for the collection of rinse/wastewater. <br />ip^aper towels and pump-style soap container. <br />Names of responsible persons to be present in booth during all hours of operation: <br />“Important** <br />^hre^compart k 'temS b°Oth Sanitary c,eanin9 of food preparation utensil <br /> Three deep fobs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br />sohjgion (one tablespoon of bleach per gallon of water). <br />[JWetergent, bleach, and wiping cloths (cleaning towels). <br />[UTubto store wiping cloths in bleach solution. <br />SAN JOAQUIN <br />a •. - ------COUNTY— <br />Greatness grows here. <br />' the fol!°Win9 COld temperature control for the cold holding of potentially hazardous foods below <br />45 F (If food is used the following dav, maintain below 41 °F temperature): <br />Q Ice chests [jiffiefrigerator <br /> Refrigerated truck |Ce bath and fobs <br /> Other (specify) _________ <br />ice Cooler