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Environmental Health Department <br />10. <br />I anrprbviding the following items within my booth for the sanitary cleaning of food preparation utensil <br />Huiree compartment sink. <br />11. <br />OR <br />12. <br />fater supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br /> On-parate tub (bucket or basin) for the collection of rinse/wastewater. <br />Paper towels and pump-style soap container. <br />13. <br />14.Completed by: <br />Signature <br />Health Permit <br />Paper Hand Towels <br />Soap dispenser <br />Cutting Board <br />BleachPropane Stove <br />Propane Tank <br />fl <br />Ice Cooler <br />r»r aa r <br />------------ ......,,, <br />Extra Ice Begs & Food Containers must be <br />stored 6 inches off of the ground! <br />Extra <br />Water <br />5 Gal Hand wash <br />Wastewater Container <br />Garbage <br />Can' <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping doths <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, ora Tarp. <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />Stemo wfChaffing <br />Dish <br />5-20 Gal. <br />Hand wash Water <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 />this event. <br />** Important** <br />VVWY_ <br />Date <br />Names of responsible persons to be present in booth during all hours of operation: <br />. ci______ ________________________ <br />Q^fhree deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br />solultorffonp-tablespoon of bleach per gallon of water). <br />[^peter^ent, bleach, and wiping cloths (cleaning towels). <br />□Tub to store wiping cloths in bleach solution. <br />~iLI Fire Extinguisher <br />; SAN JOAQUIN <br />•_ ... ’ ------COUNTY------ <br />fl.fl.-..-’ Greatness grows here. <br />I am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br />4^°F (if food is used the following dayjrjaintain below 41 °F temperature): <br />Eflce chests □Refrigerator <br /> Refrigerated truck Ice bath and tubs <br /> Other (specify)— _____________________________________ <br />Soot <br />Soap and Water Rinse Water