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Environmental Health Department <br />10. <br />11. <br /> Three compartment sink. <br />OR <br />12. <br />13. <br />14.Completed by: <br />Health Permit <br />Paper Hand Towels <br />Soap dispenser <br />Cutting Board 1Propane Stove Bleach <br />Propane Tank <br />Fire Extinguisher <br />EHD^eS Hazelton Avenue 1 StOckton' California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjcehd.com <br />mm a t Page 8 of 11 TEMP EVE MlTEMP EVENT APP07/3/17 <br />Soap and Water <br />Extra Ice Bags & Food Containers must be <br />stored 6 inches off of the ground! <br />Stemo w/Chaffing <br />Dish <br />5 Gal Hand wash <br />Wastewater Container <br />Garbage <br />Can <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping cloths <br />5-20 Gal. <br />Hand wash Water <br />’’Important** <br />Date <br />Rinse Water <br />Ice Cooler <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 /> <br />Signature <br />lann providing the following items within mv booth for the sanitary cleaning of food preparation utensil <br /> Three compartment sink. (J, <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 /> Detergent, bleach, and wiping cloths (cleaning towels). <br /> Tub to store wiping cloths in bleach solution. <br />^=□1 I <br />^Paper towels and pump-style soap container. <br />Names of responsible persons to be present in booth during all hours of operation: <br />______f y a t- |4 4 r t J <br />SAN JOAQUIN <br />------COUNTY------- <br />Creotness grc^s r.ere. <br />' the followin9 cold temperature control for the cold holding of potentially hazardous foods below <br />F (if food is used the following day, maintain below 41 °F temperature): <br />Ice chests [J Refrigerator <br /> Refrigerated truck [J Ice bath and tubs <br /> Other (specify) <br />booth-PrOVidin9 the f0"0Win9 f0r ade9uate hand washing facilities, but separate from utensil wash within my <br />nt Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />[?fcne separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, ora Tarp.___ J <br />Title <br />Extra <br />Water