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■aassBwi <br />Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br />'[71 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 />13. <br />Completed by: 14.Titleire <br />Health Permit <br />! <br />PafM Hand TnM«« <br />CdSingBoM <br />PnMwwTaM <br />BttdiantfWMr <br />■£7 <br />fl <br />if -^7 <br />Doh <br /> ExM <br />5-20 Gal <br />HandwMhWMn <br />SanitzefbucfcM- <br />Meach a mum fot <br />storing wKXig do*w <br />_____ <br />Ice Cooler <br />SAN JOAQUIN <br />COUNTY <br />------- <br />iBt_Z_ <br />Arm Water <br />7^^: <br />"Important** <br />&MPNKIMMW <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 following day, maintain below 41 °F temperature): <br />Ice chests Refrigerator <br /> Refrigerated truck Ice bath and tubs <br /> Other (specify)_____ <br />F 209 464-0138 | www sjgov.org/ehd <br />TEMP EVENT APP <br />1 <br />1868 E. Hazelton Avenue | Stockton. California95205I T 209 468-3420 | <br />EHOIM2 <br />(W1W19 <br />I SoapdapanMt <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> Three compartment sink <br />SGNHMMwMh <br /> 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 /> Detergent, bleach, and wiping cloths (cleaning towels). <br /> Tub to store wiping cloths in bleach solution. <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />2 <br />Garbage <br />Can <br />--------------------—. <br />Booth must be on <br />Concrete, Asphalt. <br />Plywood, ora Tarp <br />Q Paper towels and oumo-stYte soap container. <br />Names ofresponsible persons to be ppasent in booth during all hours of operation: <br />(Q yi -----------------------—------ <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