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■ wnm------1-~~ <br />Environmental Health Department <br />11. <br />OR <br />12. <br />EJ Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />13. <br />“Important** <br />Completed by: 14. <br />lg nature <br />Health Permit <br />Paper Hand Towels <br />Soap dispenser <br />Cutting Board <br />BleachPropane Stove <br />u <br />Soap and Water <br />]Fire Extinguisher <br />Ice Cooler <br />EHD 16-02 <br />07/3/17 <br />Extra Ice Bags i Food Containers must be <br />stored 6 Inches oft of the groundl <br />Sterno w/Chaffing <br />Dish <br />Garbage <br />Can <br />Booth must be on <br />Concrete, Asphalt. <br />Plywood, or a Tarp. <br />''K^One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />□ Paper towels and pump-style soap container. <br />Extra <br />Water <br />5-20 Gal. <br />Hand wash Water <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping cloths <br />5 Gal Hand wash <br />Wastewater Container <br />10. <br />mA <br />Names of responsible persons to be present in booth during all hours of operation: <br />'Exbryu tb-r l< In 3 <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />□ Three compartment sink. <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 />K 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 />________iXiCtd ___________ <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 operaiiopi. Return original to festival coordinator three weeks prior to <br />this event. ~ <br />Propane Tank <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 [ www.sjcehd.com <br />- :c C2 Page 8 of 11 TEMP EVENT APP <br />SANJOAOUIN <br />------COUNTY------ <br />G/eotness grows here. <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 />’S] Ice chests O Refrigerator <br />□ Refrigerated truck TE^Ice bath and tubs <br />□ Other (specify),---------------------------------- -------------------------------------------------------------------------------------- <br />----------- <br />Rinse Water