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Bleach and Water <br />Sterra wrhal fin, <br />Dish <br />Soap dispenser dispenser <br />Paper Hand Toilets <br />Saneiaer becket- <br />blench &water ter <br />storing itorins cluhs <br />f <br />Booth must be on <br />Concrete, Asphalt <br />Plywood, or a Tarp. <br />Cutting Board <br />Propane Stove <br />Soap and Water <br />- <br />Ertta iee Ethos & Food Contahers thus' be <br />stared 6k-dies oil of the gram& <br />5-20 Gal. <br />Hand wash Water Health Penn <br />Rasa Water <br />5 Gal Hand wash <br />War-tem:0er Callainer <br />Garbage <br />Can <br />DocuSign Envelope ID: A6E74685-DEDE-4900-90F6-8D6DC4F9DF9A <br />R EC-008 <br />SAN JOAQUIN <br /> <br />Environmental Health Department <br />—COUNTY — <br />Greatness 9row5 here. <br />10. 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 /> <br />Ice chests <br />efrigerated truck <br />Other (specify) <br /> <br />Refrigerator <br />Ice bath and tubs <br />c //: (63/0,:td,1 ZAirr <br /> <br />161.1•••MM.. <br /> <br />11. providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />ree compartment sink. <br />OR <br />ree deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br />on (one tablespoon of bleach per gallon of water). <br />tergent, bleach, and wiping cloths (cleaning towels). <br />ub 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 />5/ater supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />El)ne separate tub (bucket or basin) for the collection of rinse/wastewater. <br />[Raper towels and pump-style soap container. <br />Names of responsible persAs to be present in booth 5(wing all hArs of oper)ation: <br /> go4/X410 — ieose—///_ <br />"Important** <br />14. Completed by: <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 />2.1443 event/. <br />0.41/P/ <br />Signature <br />--- 2 V SUBMIT <br />Title Date <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sigov.orgtetid <br />AID 16-Q2 Page8of 11 MAP EVENT APP <br />0619'19