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Environmental Health Department <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 spigot). <br />13 One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />0 Paper towels and pump-style soap container. <br />13. <br />“Important** <br />iti- <br />Completed by:14. <br />nat/ire <br />Health Permit <br />Paper Hand Towels <br />Soap dispenser <br />Culling Board <br />B'enchPropane Stove <br />1 <br />Piopane Tank <br />Bleach and WalerRinse Waler <br />Fire Extinguisher <br />Ice Cooler <br />TEMP EVENT APP <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />0 Three compartment sink. <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 />Eito Ice Begs & food Cor'Miriers must be <br />sloied 6 inches off of (he ground! <br />5 Gal Hand wash <br />Wastewater Cc«Mai<>er <br />Garbage <br />Can <br />Sanitizer bucket­ <br />bleach & watw (or <br />Storing wiping cloths <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />Names of responsible persons to be present in booth during all hours of operation: <br />Ana Gwerder <br />SI emo w/Chatting <br />Dish <br />5 20 Gal. <br />Hand wash Waler <br />Elba <br />Waler <br />SAN JOAQUIN <br />------COUNTY------ <br />Jo_± <br />Soap and Waler <br />All food vendor booths are, <br />preparation for this <br />preparation and opc <br />this/frvent. xj <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 To keeP chocolate items cold <br /> Refrigerated truck Ice bath and tubs <br /> Other (specify)________________________________________ <br />l^iect to inspection. Please make a copy of this application in <br />Acbpy of this checklist must be in the booth at all hours of <br />Return original to festival coordinator three weeks prior to <br />Tiile Date <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />EHD 16-02 Page 0 of 11 TEMP EVENT A! <br />07/01/2024