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Environmental Health Department <br />-S <br />10. <br /> Three compartment sink. <br />12. <br />13. <br />14.Completed by: <br />Signature <br />Paper Hand Towels <br />Soap dispenser <br />Cutting Board <br />Propane Stove Bleach <br /> r <br />j If <br />Bleach and Water <br />Fire Extinguishera <br />Ice Cooler <br />Page 8 of 11 <br />■__________________________ ' <br />I <br />Stemo w/Chaffing <br />Dish <br />5 Gal Hand wash <br />Wastewater Container <br /> Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Q Paper towels and pump-style soap container. <br />□-ZO Gai <br />Hand wash Water <br />Extra <br />Water <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping cloths <br />Rinse Water <br />h°urs °f oPerat*on: <br />11 ■ Q Thn^comio^rtm''T'HkWithin my sanitary c,eanin9 ofpreparation utensil <br />OR mpa 60 S'n ’ <br />TT l~ <br />Soap and Water <br />“Important <br />Extra Ice Bags & Food Containers must be B <br />stored 6 inches off of the ground! [ ] <br />Propane Tank <br />----------------------------1 <br />R 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 /> Detergent, bleach, and wiping cloths (cleaning towels). <br />13 Tub to store wiping cloths in bleach solution. <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 foe booth at all hours of <br />preparation and operation. Return original to festival coordinator three weeks prior to <br />Title Date <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420] F 209 464-0138 | www.sigov.org/ehd <br />06/29/2023 P”96 8 °f 11 TEU'’ APP <br />Healthi Permit p <br />boofoPr°VIC,in^ fo,lowin9 for ade<luate hand washing facilities, but separate from utensil wash within my <br />SANJOAOUIN <br />—-COUNTY------ <br />Greatness here. <br />1 ,the fol,owin9 cold temperature control for foe cold holding of potentially hazardous foods below <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 />Garbage <br />Can <br />—----\ <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />__ ______________z