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Enviro I Health Department <br />10.itentially hazardous foods below <br />iod preparation utensil11. <br />OR <br />for rinsing and one for a bleach <br />'ate from utensil wash within my12. <br />S Water supply dispenser with warm water at a minimum of 100ol::jallon container with spigot). <br /> One separate tub (bucket or basin) for the collection of rinse/w;id <br /> Paper towels and pump-style soap container. <br />13.ion: <br />ill <br />14.Completed by: <br />DateSignature <br />Health Permit <br />]Paper Hand Towels <br />Soap dispenser <br />Cutting Board <br />BleachPropane Stove <br />I <br />Propane Tank <br />Bleach and Water <br />Fire Extinguisher <br />Ice Cooler <br />Soap and Water Rinse Water <br />I am providing the following for adequate hand washing facilities <br />booth: <br />I am providing the following items within my booth for the sanitary <br />E Three compartment sink. <br />Extra Ice Bags & Food Containers must be <br />stored 6 inches off of the ground! <br />5 Gal Hand wash <br />Wastewater Container <br />nake a copy of this application in <br />t be in the booth at all hours of <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, ora Tarp. <br />0 Three deep tubs (basins 6-8 inches minimum), one for soapy d <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 />Extra <br />Water <br />5-20 Gal. <br />Hand wash Water <br />Stemo w/Chaffing <br />Dish <br />Names of responsible persons to be present in booth during all ho. <br />Joe and Rernadette Spencer.................................. .................... . <br />Oyvner/Operator <br />Title <br />SAN JOAQUIN <br />------COUNTY------- <br />Greatness grows here. <br />I am providing the following cold temperature control for the cold <br />45°F (if food is used the following day, maintain below 41°F tem| <br /> Ice chests Refrigerator <br />0 Refrigerated truck Ice bath and tubs <br /> Other (specify) <br />All food vendor booths are subject to inspectior <br />preparation for this event. A copy of this checKlisi <br />preparation and operation. Return original to festival coordinator three weeks prior to <br />this event. <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />EHD 16-02 Page 8 of 11 TEMP EVENT APP <br />06/19/19 <br />‘‘Important**