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Environmental Health Dep;:; nt <br />10. <br />11. <br />OR <br />12. <br />0 Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with sp'nc-^. <br /> One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />0 Paper towels and pump-style soap container. <br />13. <br />Completed by:14. <br />Health Permit <br />I So»p dispenser <br />Cutting Board <br />Bleach <br />Propane Stove <br />DU 01 <br />Bleich and Waler <br />Fire Eilloguisbar <br />.. /'PR <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> Three compartment sink. <br /> Three deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a !' -ach <br />solution (one tablespoon of bleach per gallon of water). <br />0 Detergent, bleach, and wiping cloths (cleaning towels). <br />0 Tub to store wiping cloths in bleach solution. <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash wi n my <br />booth: <br />F«/r« /co Bags 4 Food Containers must be <br />stored 6 inches off of the ground.’ <br />5 Gal Hand wash <br />Wastewaler Container <br />5-20 Gal. <br />Hand wash <br />Garbage <br />Can <br />C <br />F <br />n in <br />-s of <br />r to <br />Names of responsible persons to be present in booth during all hours of operation: <br />Mike Bacchetti <br />Sterno w/Chaffing <br />Dish <br />E«tra <br />Waler <br />•*rtor <br />rl ;:.s <br />SAN JOAQUIN <br />COUNTY------ <br />Greatness 5 '.--c. <br />I am providing the following cold temperature control for the cold holding of potentially hazardous foo.'s be'ow <br />45°F (if food is used the following day, maintain below 41 °F temperature): <br />0 Ice chests Refrigerator <br /> Refrigerated truck Ice bath and tubs <br /> Other (specify)— <br />4 mF <br />. | P ' ' ■ ‘8 j <br />I <br />Soap and Waler Rinse Waler <br />Propane Tank <br />/ <br />B ?. must be on <br />•e, Asphalt, <br />■ or a Tarp. <br />Ice Cooler <br />‘•Important**All food vendor booths are subject to inspection. Please make a copy of this ap, : <br />preparation for this event. A copy of this checklist must be in the booth at ail I' <br />preparation and operation. Return original to festival coordinator three weeks : <br />thiSS s-ai-ar <br />SigrrahuJ * Title DateTitle <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjf <br />EHD 16-02 Page 8 of 11 <br />07/01/2024