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Environmental Health Department <br />11. <br />OR <br />12. <br />13. <br />14. <br />Health P <br />Paper Hand Towels <br />Soap dispenser <br />I Bleach <br />a <br />Propane Tank <br />Bleach and Water <br />Fire Extinguisher <br />Jhd Ha2elton AveniJe I Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sicehd.com <br />07/Sl7 P-seBofll TEMP EVENTTEMP EVENT APP <br />10. <br />Stomo w/Chaffinfl <br />OWr <br />laintain below 41 °F temperature): <br />Refrigerator <br />□ Ice bath and tubs <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />Extra Ice Bags & Food Containers must be <br />stored 6 inches off of the ground! <br />5 Gal Hand wash <br />Wastewater Container <br />5-20 Gal. <br />Hand wash Water <br />Sanitizer bucket­ <br />bleach & waler far <br />storing wiping cloths <br />j/* <br />Garbage <br />Can <br />Title <br />Cutting Board <br />Propane Stove - <br />"Important** <br />Ice Cooler____r <br />^■hree'compart foll°tWin9k 'temS within my booth for the sanitary cleaning of food preparation utensil <br />R Ihref deeP^bs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br />sokjaon (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 />u^T <br />LoaofoPr°"din9 the fo,low,n9 for adequate hand washing facilities, but separate from utensil wash within my <br />l^^ter supply dispenser with warni water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />^T)ne separate tub (bucket or basin) for the collection of rinse/wastewater. <br />^P'Faper towels and pump-style soap container. <br />Names of responsible persons to be present in booth during all hours of operation: <br /> <br />ANfood^vendor booths are subject to inspection. Please make a copy of this application in <br />preparation and operation. Return original to festival coordinator three weeks prior to <br /> (a -2^^ <br />Date <br />FT I L. <br />] / <br />Soap and Water Rinse Water <br />SAN JOAQUIN <br />------COUNTY------ <br />Greatness grows here. <br />providing the following cold temperature control for the cold holding of potentially hazardous foods below <br />'I T t <br />I am | <br />45°F (if food is used the foffowing da' <br />□ Ice chests <br />□ Refrigerated truck <br />□ Other (specify) <br />pre^aratjon for this event. A copy of this checklist must be in the booth at all hours of <br />r ———. ■ .v u.iu, i. , vi H411 <br />Completed by: <br />Signature <br />Extra <br />Waler