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Environmental Health Department <br />10. <br />12. <br /> . vdter supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />13. <br />‘‘Important" <br />14.Completed by: <br />Signature Date <br />Paper Hand Towels <br />Soap dispenser <br />Culling Board <br />Propane Slove <br />i <br />) <br />Ice Cooler <br />id^separate tub (bucket or basin) for the collection of rinse/wastewater. <br />_Her towels and pump-style soap container. <br />Exira Ice Bags & Food Containers must be stored 6 inches off of the ground! <br />Slemo w/Chaffing <br />Oish <br /> Extra <br />Water <br />5 Gal Hand wash <br />Wastewater Container <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 />5-20 Gal. <br />Hand wash WaterHealth Permit 1 <br />Title <br />r <br />Rinse Water <br />7 <br />Soap and Water <br />• ^r^rol/iding the following items within my booth for the sanitary cleaning of food preparation utensil <br />OR compartment sink. <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 /> /f- 7- Z3 <br />deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br />solupdn (one tablespoon of bleach per gallon of water). <br />B'D^tergent, bleach, and wiping cloths (cleaning towels). <br />[^JzTub to store wiping cloths in bleach solution. <br />^atr^providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />Garbage <br />Can <br />1868 E. Hazelton Avenue | Stockton, California 952051 T 209 468-3420 | F 209 464-0138 | www.sjcehd.com <br />EHD 16-02 Page fl of 11 TEMP EVENT APP <br />07/3/17 <br />I Bleach <br />I Propane Tank <br />SAN JOAOUIN <br />-----COUNTY------ <br />(.'I t11.) I. ne vs <br />I am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br />F (if food is usod tho following day, maintain below 41 °F temperature); <br />Tests Refrigerator <br />^-^igerated truck - Q Ice bath and tub^ <br /> Other (specify)’ <br />Names of responsible persons to be present in booth during all houra of operation. <br />___________or' <br />“L i