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Environmental Health Department <br />9. <br /> Stemo & hotel trays <br /> Double steamer Steam table & lids <br /> Electric stove top Other (specify) <br />meats, tamales, cooked beans, rice, <br />10. <br />Other <br />11.I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />XjLjhree compartment sink. <br />OR <br />12. <br />ne separate tub (bucket or basin) for the collection of rinse/wastewater. <br />^-Eaper towels and pump-style soap container. <br />13. <br />’’Important** <br />14.Completed by: <br />Health Permit <br />Paper Hand Towels <br />Soap dispenser <br />Cutting Board <br />Propane Stove Bleach <br />iue | S <br />I I <br />1868 E. Hazelto <br />EHD 16-02 <br />07/01/2025 <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />Sterno w/ChaffingDish <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping cloths <br />5-20 Gal. <br />Hand wash Water <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp.o <br />Haye o ui iz <br />Signature <br />■^Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products. <br />I am providing the following cold temperature control forthe cold holding of potentially hazardous foods below <br />45°F (if food is used the following day, maintain below 41°F temperature): <br />JSJce chests Refrigerator <br /> Refrigerated truck Ice bath and tubs <br /> <br />(specify). <br />SAN JOAQUIN <br />------COUNTY <br />Greatness grows here. <br />I am providing the following hot temperature control forthe hot holding of all potentially hazardous foods above <br />135°F: <br />-^dlcamp stove <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 />thisVevenf. , ^") , / <br />Title Date <br />■Suhree deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one fora bleach <br />solution (one tablespoon of bleach per gallon of water). <br />‘'^Detergent, bleach, and wiping cloths (cleaning towels). <br />'D'Tub to store wiping cloths in bleach solution. <br />Names of responsible persons to be present in booth during all hours of operation: <br />\ Obe zx✓) Q —