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Environmental Health Department <br />10. <br />Ice bath and tubs <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 />One separate 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 />re <br />Paper Hand Towels <br /> Soap dispenser <br />Cutting Board <br />BleachPropane Stove <br />Propane Tank <br />Rinse Water Bleach and Water <br />Fire Extinguisher <br />5 Gal Hand wash <br />Wastewater Container <br />5-20 Gal. <br />Hand wash Water <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping cloths <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, ora Tarp- <br />Sterno w/Chafflng <br />Dish <br />Extra <br />Water <br />----- ---------/ <br />Ice Cooler <br />___ <br />-—7. ..... <br />Health Permit <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 <br /> <br />Title Date <br />‘‘Important** <br />1 I . -.I <br />Soap and Water <br />Extra Ice Bags & Food Containers must be <br />stored 6 Inches off of the ground! <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 />I am providing the following for adequate hand washing facilities, but separate from utensil wash within mv <br />booth: <br />Names of responsible^persons to be present in booth during all hours of operation: <br /> <br />SAN JOAQUIN <br />-----COUNTY----- <br />■JI.. Greatness throws 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 /> Ice chests Refrigerator <br /> Refrigerated truck <br />^pther (specify) <br />lam providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />JZ-Three compartment sink. <br />Garbage <br />Can <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjcehd.com <br />OT/Sl?6'02 Pa9e 8 0111 TEMP EVENT APP <br />.