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Environmental Health Department <br />10. <br />□ Three compartment sink. <br />12. <br />13. <br />14.Completed by: <br />Signature <br />Paper Hand Towels <br />Soap dispenser <br />Culling Board <br />Propane Stove Bleach <br />it <br />Soap and Water Rinse Water Bleach and Water <br />. .... . <br />Names of responsible persons to be present in booth during all hours of operation: <br /> 4- <br />\ <br />Exira ice Bags & Food Containers must be <br />stored 6 Inches off of the gioundl <br />Stemo w/Chafling <br />Dish <br />Extra <br />Water <br />5 Gal Hand wash <br />Wastewater Container <br />Garbage <br />Can <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping cloths <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />Ice Cooler <br /> r <br />6-20 Gal. <br />Hand wash Water <br />E Water supply dispenser with warm water at a minimum of 100T (i.e. 5-20 gallon container with spigot). <br />Q One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Q Paper towels and pump-style soap container. <br />Propane T ank <br />‘‘Important** <br />11. lam providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />U Three compartment sink. - . . <br />OR <br />■rsU' <br />S 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 />E Detergent, bleach, and wiping cloths (cleaning towels). <br />Q Tub to store wiping cloths in bleach solution. <br />Boun Ouk & Emily Ouk <br />All food vendor booths are subject to inspection. Please makeT^y’of this ap^ication 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 />in is event, - - <br />Sole Business Owner11 4^2024 <br />Title Date <br />EH8oto2Ha26lt0nAVenUe| Stockton, California 95205 | T 209 468-3420) F 209 464-0138 | www.sjcehd.com <br />0773/17 ragoBofll TEMP EVENT APP <br />/'•'f A. SAN JOAQUIN <br />■' ------COUNTY- <br />'i.i,' Greolne.ss j/roivs /iere. <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 foflowing day, maintain below 41°F temperature): <br />[xt Ice chests Q Refrigerator <br />□ Refrigerated truck E Ice bath and tubs <br />□ Other (specify), _____ <br />Health Permit I <br />booth^OVidin9 the f°ll0Win9 f°r adec'uate hand washir,g facilities, but separate from utensil wash within my