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Environmental Health Department <br />OR <br />12. <br />O Paper towels and pump-style soap container. <br />13. Names of responsible persons to be present In booth during all hours of operation: <br />’’‘Important’* <br />Completed by: 14. <br />Signature <br />Paper Hnd Tornote <br />Cutina Board <br />BlaaohPrapmaSiovt <br />Profane Twik <br />HraEsrngutahw <br />TEMP EVENT APPPaga 8 efl 1 <br />festeagri <br />Health Permit <br />L____■_ <br />RtonWatw <br /> Water supply dispenser with warm water at a minimum of 100°F (i.a. 6-20 gallon container with spigot). <br /> One separate tub (bucket or basin) for the collection of rinseAvastewater. <br /> Three deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br />solution (one taWeapoon of bleach per gallon of water). <br /> Detergent, bleach, and wiping cloths (cleanbig towels). <br /> Tub to store wiping cloths in bleach solution. <br />Entm /m ft Food CoAtetosB mfttb* <br />ttOTBd 0 Miit Off Of (he gnwmff <br />0 Qal Hand wssfi <br />WMtewwWrCDntafrwr <br />8«nttKbuQi«t- <br />Haeufi ft water for <br />•taring wpng doth* <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />45°F (if food is used foe following day, maintain below 41 °F temperature): <br /> Ice chests Refrigerator <br /> Refrigerated truck Ice bath and tubs <br /> Other (specify) ____________________ <br />BtemoWCbafftTfl <br />Dteh <br />Ice Cooler /. <br />I <br />Soap Btf Water <br />1 Booth must be an <br />Concrete, Asphalt, <br />Plywood, ora Tarp. <br />11. lam providing the following Items within my booth for the sanitary cleaning offood preparation utensil <br /> Three compartment sink. <br />_______ <br />MO Sal. <br />HandwaahWator <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 /> <br />Title Date <br />Qarbage <br />Can <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209464-0138 | www.fijoehd.com <br />EHD 18-02 PaflaBoHI TE?.” EVENT <br />orartT <br />i l 5? 4 J <br />------Fn <br />Btafih and Water I [ <br />SANJOAOUIN <br />-----COUNTY------ <br />Greofnoss grows here. <br />10. I am providing the following cold temperature control for the cold holding of potentially hazardous foods below