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Environmental Health Department <br />11. <br />OR <br />12. <br /> One separate tub (bucket or basin) for the collection of rinse/wastewater. <br /> Paper towels and pump-style soap container. <br />Names of responsible persons to be present in booth during all hours of operation:13. <br />"Important** <br />14.Completed by: <br />| Heald; Permit <br />Paper Hand Towels <br />Propene Stove <br />Soap and Water Rinse Water Bleach and Water <br />5 Gal Hendwaah <br />Wastewater Conttner <br />5-2D G^. <br />Hwitf WMh Water <br />Garbage <br />Can <br />exfrp /co Baga & Food Coniainera nwat tw <br />stowi 8 OTc/itw uff of [he ground <br />Sen Itlzar tucket <br />WrachS water for <br />storing wiping doVis <br />Stemo wChaffrig <br />Dtsh <br />(27tx-r?^>r~ <br />Title <br />C____c <br />Signature <br /> Water supply dispenser with warm water at a minimum of 100’F (l.e, 5-20 gallon container with spigot). <br />Date <br /> Booth must be on <br />Concrete, Asphalt. <br />Plywood, oraTaip. <br /> _______________________________i <br />r'^S^ <br />10. <br />Soao dteoensar <br />Ice Cooler <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />SAIWOAQUIN <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 /> Ice chests Refrigerator <br /> Refrigerated truck Ice bath and tubs <br />O Other (specify)______________________________________________ <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> Three compartment sink. <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 event. <br /> 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 /> Detergent, bleach, and wiping cloths (cleaning towels). <br /> Tub to store wiping cloths in bleach solution. <br />Prop tna Tank <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 [ www.sjcehd.com <br />EHD 16-02 Page 8 of 11 TEMP EVENT APP <br />07/3/17 <br />CJttlnfl Boarti <br />Flna ExtinfluishHr