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Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br />□ Water supply dispenser with warm water at a minimum of 100T (i.e. 5-20 gallon container with spigot). <br />EZI One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />iper towels and pump-style soap container. <br />Names of responsible persons to be present in booth during all hours of operation:13. <br />iths are subject to inspection. Please make a copy of this application in <br />Completed by: 14. <br />Title <br />Health Permit <br />Paper Hand Towels <br />Soap dispenser <br />Cutting Board <br />BleachPropane Stove <br /> <br />Propane Tank <br />Fire ExtinguisherQz <br />Ice Cooler <br />Extra Ice Bags & Food Containefs must be <br />stored 6 inches off of the ground! <br />Extra <br />Water <br />5 Gal Hand wash <br />Wastewater Container <br />5-20 Gal. <br />Hand wash Water <br />All food vendor bloths 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 />preparatii <br />this evei <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping dottis <br />SAN JOAQUIN <br />------COUNTY------ <br />' Greatness grows here <br />I am providi <br />45OE <br />StemoMtfCt <br />Dish <br />"Important** <br />and operation. Return original to festival coordinator three weeks prior to <br />— <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />.^.iding the following cold temperature control for the cold holding of potentially hazardous foods below <br />^iffood is used the following day, maintain below 41 ’F temperature): <br />[~jHce chests O Refrigerator <br />Q Refrigerated truck Q Ice bath and tubs <br />□ Other (specify) ------------------------ -------------------------------------------------------------------------------------- <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjcehd.com <br />EHD 16-02 Page 8 of 11 TEMP EVENT APP <br />07/3/17 <br />•* <br />Garbage <br />Can <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />□ Three'compartment sink. <br />Cfrhree 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 my <br />booth: <br />Soap and Water Rinse Water