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REC-008 <br />Environmental Health Department <br />heiv s <br />10. <br />11. <br />OR <br />12. <br />Q Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />O’ One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Q Paper towels and pump-style soap container. <br />13.Names of responsible persons to be present in booth during all hours of operation: <br />Alma Pineda, Kamila Carter, Ryan Carter <br />“Important** <br />this event.Owner 07-15-202614.Completed by: <br />Title Date <br />Paper Hand Towels <br />Soap dispenser <br />Cuttma Board <br />BleachPropane Stove <br />I <br />Propane Tank <br />Rinse Waler Bleach and Waler <br />Pre Extinguisher <br />0 <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />Three compartment sink. <br />Extra tee Bags & Food Conianers must be <br />stored 6 inches ott of the ground! <br />Sterno w'Chalfing <br />Dish <br />Garbage <br />Can <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping cloths <br />Booth must be on <br />Concrete. Asphalt. <br />Plywood, or a Tarp. <br />ss gr <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 />Ice chests □Refrigerator <br />□ Refrigerated truck Q- Ice bath and tubs <br />□ Other (specify) <br />5 Gal Hand wash <br />Wastewater Container <br />5-20 Gal. <br />Hand wash Waler <br />SAN JOAQUIN <br />-COUNTY— <br />Great r <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 />------------------------- GzxOS car ------------------------ <br />oiynaiuic <br />I <br />Soap and Waler <br />Q 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 />Q Detergent, bleach, and wiping cloths (cleaning towels). <br />QTub to store wiping cloths in bleach solution. <br />Ice Cooler j <br />________________V <br />| Health Permit <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />EHD 16-02 Page 8 of 11 TEMP EVENT APP <br />06/19/19 <br />Extra <br />Wafer