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Environmental Health Department <br />11. <br />OR <br />12. <br /> Paper towels and pum /lesoap container. <br />13.Names of responsible persons to be present In booth during all hours of operation: <br />“Important** <br />h anchoperation.. <br />Signature <br />14. Completed by: <br />Health Permit <br />1 Paper HoxIToMla <br />Soapdleparaer <br />Cuttna Board <br />BleaoTiPrapanaatove <br />3a <br />Propane Task <br />Rlnae WaterBoep and Waler BIm* and Waler <br />FPoBtrcuMer <br />PBfleaofH <br />is <br />K <br />BID 1M2 <br />07/3/17 <br /> Water supply dispenser with warm water at a minimum of 100°F (l.e. 5-20 gallon container with spigot). <br /> One separate tub (bucket or basin) for the collection of rinse/Waetewater. <br />Brfra iaa flaji A Fmd CtuMnan mutt <br />Biawt b imhu uttttfbm gnundl <br />Extra <br />Water <br />45°F (if food Is used the following day, maintain below 41 “F temperature): <br /> Ice chests Refrigerator <br /> Refrigerated truck tee bath and tubs <br /> Other (specify)___ _______________________ <br />BCM Hand wash <br />Wutemtir CcnMner <br />BfemowIChaflrnfi <br />Dhh <br />GcnIUur buokat- <br />btefloh Awatorfcr <br />ttoring iMfpfhg ckrttw <br />Ice Cooler <br />__ <br />. SAN JOAOUIN <br />.• ------COUNTY'------ <br />Greatness grows here. <br />in for this event A copy of this checklist must be in the booth at ell hours of <br />letivei coordinator three weeks prior to <br />Title Ddte <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 (deanlng towels). <br /> Tub to store wiping cloths in bleach solution. <br />lam providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> Three compartment sink. <br />6-20 GbJ. <br />Hand wuh Water <br />buutli^110^^^ <fie foI,QW*n® for a^8cJuate har|d washlng facilities, but separate from utensil wash within my <br />id . <br />Garbage <br />Can <br />1868E. Hazelton Avenue I Stockton, California 95205 | T 209468-3420] F 209 464-0138 | www.sjoehd.com <br />/-----------------------Booth must be on <br />Concrete, Asphalt, <br />Plywood, ora Terp. <br />10. I am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br />All food vendor booths are subject to Inspection. Please make a copy of this application in <br />proparstip*1 ^r1** ai*an4 A 4Wn AU. — & —n i_____ <br />prepa <br />thls^irn original to fe; • • □7 K - <br />IH) Title