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REC-008 <br />Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br />Q Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />O’One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />O’ Paper towels and pump-style soap container. <br />13. <br />“Important** <br />this event.Owner 09-17-202514.Completed by: <br />Title Date <br />Health Permit <br />Paper Hand Towels <br />Soap dispenser <br />Cuttinq Board a BleachPropane Stove <br />IE1 <br />Propane Tank <br />J- ’Rinse Waler Bleach and Waler <br />Pre Extinguisher <br />EHD 16-02 <br />06/19/19 <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />Extra Ice Bags <S Food Containers must be <br />stored 6 inches otl ol the ground! <br />Sier no w Chai ling <br />Dish <br />Exira <br />Waler <br />5 Gal Hand wash <br />Wastewater Container <br />Garbage <br />Can <br />Sanitizer bucket­ <br />bleach & water for <br />slonng vuptng dolhs <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, ora Tarp. <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> Three compartment sink. <br />5-20 Gal. <br />Hand wash Waler <br />Ice Cooler <br />I 7<k5c7»» W16 48M BM1 Cl»«Ktrtlc*Ooiynaiuic <br />Q 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 />Q Detergent, bleach, and wiping cloths (cleaning towels). <br />Q- Tub to store wiping cloths in bleach solution. <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 />vta GowOS com <br />__Z <br />Soap and Water <br />Names of responsible persons to be present in booth during all hours of operation: <br />Samantha Nolasco Faith Previteria <br />1868 E. Hazelton Avenue | Stockton. California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />trLJr>*e''0 Page 8 of 11 TEMP EVENT APP <br />SAN JOAQUIN <br />------COUNTY------ <br />fr <br />Greotness grows 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 />Q Ice chests Refrigerator <br /> Refrigerated truck Ice bath and tubs <br /> Other (specify)