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gnvlronmentai Healt tea <br />10. <br />11. <br />OR <br />12. <br />13. <br />“Important’ <br />Completed by:14. <br />1)Sign. <br />i <br />Paper Hand Towe's <br />Soap dispenser <br />Cuttino Soard <br />J BleachPropene Stove <br />I <br />Propane Tank <br />Bleach and WaterSoap and Water <br />Fire Extinquisher <br />i Ice Cooler <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />Storno w/Chafllng <br />Dish <br />Extra <br />Water <br />5 Gai Hand wash <br />Wastewater Container <br />5-20 Gal. <br />Hand washWater <br />Garbage <br />Can <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp- <br />........................ ' <br />Health Permit <br />Title <br />.........................................................................................■..................................................................................... <br />Extra lea Bogs & Food Containers must be <br />storod 6 inches off of the gmnnal <br />± <br />Rinse 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 /> ~~ o/iUUK <br />/6ate/ <br />larn 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 />Kj Detergent, bleach, and wiping cloths (cleaning towels). <br />j/j Tub to store wiping cloths in bleach solution. <br />SAN JOAQUIN <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 />^3 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 />JZ5 Paper towels and pump-style soap container. <br />Names of responsible persons to be present in booth during all hours of operation: <br />1868 P. Hazelton Avenue i Shckhn. 9S206 | T 2V7 468-3420 | F i www sjcand.com <br />EHO 16-02 Page 8 of 11 TEMP EVENT APP <br />07/3/17 <br />Sanitizer bucket- <br />_ bleach & water for <br />/ storing wiping clothsu