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Environ me nta I Hea Ith Depa rtment <br />10 <br />11 <br />OR <br />Water supply dispenser with warm water at a minimum of 100”F (i.e. 5-20 gallon container with spigot) <br />IJ One separate tub (bucket or basin) tor the collection of rinse/wastewater. <br />!] Papei towels and puni£^tyte soan container <br />13. <br />' ’Important** <br />14 <br />Health Permit I <br />J Iii! . <br />! h-.1IWKh,' <br />/ <br />Ice Cooler <br />L c <br />l am providing the following items within my booth lor the sanitary cleaning of food preparation utensil <br />i^Three compartment sink <br />Booth must be on <br />Concrete Asphalt <br />Plywood oi a Tdt[) <br />■ '?/< 'h.ilti'v; <br />I htih <br />• Jill i ii.ind Aar.! i <br />1 bUiX," <br />6 VA'itf-r t'-t <br />'<) litll ■ <br />fj 2<’ <br />i t.-md .vat.ii v <br />.■'..1 <br />I am providing the following cold temperature control for tire cold holding of potentially hazardous foods below <br />45 F (if food is used the following day maintain below 41’'F temperature) <br />! 1 Ice chests fS] Refrigerator <br />[ „] Refrigerated truck K] Ice bath and tubs <br />I | Oster i '-pecifyi.......... ......... <br />SAN JOAQUIN <br />■ c tel.: I J '■ ■ <br />1868 E Hazelton Avenue | Stockton California 95205 | T 209 468-3420 | F 209 464-0138 j www sjgov org/ehd <br />EHD Ib-y,: i'jifiesofll tfmp FV6NT .uPP <br />■CT~T f <br />: ...ip i'. <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />tiOOth <br />7^ <br />I <br />L..J 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 />IJ Detergent, bleach, and wiping cloths (cleaning towels). <br />I | Tub to store wiping cloths in bleach solution <br />All food vendor booths are subject to inspection Please mate 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 />romp!e.ed by . llfiS/I'd <br />Names of responsible persons to be present in booth during all hours of operation:IpCsAn _______________________ <br />I•'r.iptft I li'ifn; I <br />/ <br /> /