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I <br />Environmental Health Department <br />10. <br />11. I apn providing the following Hems within my booth for the sanitary cleaning of food preparation utensil <br />[3 Three compartment sink. <br />OR <br />12. <br />Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />13. <br />Completed by:14. <br />Signature <br />Health Permit <br />Paper Hand Towels <br />Soap dispenser <br />Oillinq Board <br />BleachPropano Sfovo <br />Propane Tank <br />Fite Extinguisher <br />Ice Cooler <br />TEMP EVENT APP <br />Exira <br />Water <br />5-20 Gal. <br />Hand wash Waler <br />Garbage <br />Can <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />Extra Ice Baffs & Food Containers must be <br />stored 6 Inches off of the ground! <br />Slemo w/Chaffing <br />bhh <br />5 Gal Hand wash <br />Wastewater Container <br />Sanitizer bucket­ <br />bleach & waler for <br />storing wiping dolhs <br />Q'One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />[^pPapcr towels and pump-style soap container. <br />Names of responsible persons to be present in booth during all hours of operation: <br />__________ J I ? t. /' <br />/-fej ./r?/Wsry <br />**lmportan't** <br />RInso Water <br />.-nree 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 />EZf Detergent, bleach, and wiping cloths (cleaning towels). <br />0 Tub to store wiping cloths in bleach solution. <br />___L <br />Soap and Water <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 4640138 | www <br />EHD 16-02 TEMP EVE!'!-! <br />07/3/17 <br />All food vendor booths ^re 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 anjj'operation. Return original to festival coordinator three weeks prior to <br />this »■ J / "T / " ~ Z / <br />(Z? uY/i/ _____z-/ / g <br />. Title Ibate ' <br />SAN JOAQUIN <br /> COUNTY <br /><’»' di <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 /<J Ice bath and tubs <br /> Other (specify)__ _______