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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 100°F (i.e. 5-20 gallon container with spigot). <br />ne separate tub (bucket or basin) for the collection of rinse/wastewater. <br />iper towels and pump-style soap container. <br />13. <br />‘Important** <br />14.Completed bp: <br />Signatun <br />Health Permit <br />Paper Hand Towels <br />Soap dispenser <br />Cutting Board <br />Propane Stove Bleach <br />Di <br />Propane Tank <br />Rinse Water <br />Fire Extinguisherfl <br />Ice Cooler <br />~ITEZZ <br />Soap and Water <br />Extra Ico Hags i Food Containers must ba <br />stored 6 inches off of the gmundl <br />Slerno w/Chaffing <br />Dish <br />Exira <br />Water <br />5Gal Handwash <br />Wastewater Container <br />Garbage <br />Can <br />Sanitizer bucket- <br />Ucach 6 water (o' <br />storing wiping cloths <br />Booth must be on <br />Concrete, Asphalt. <br />Plywood, or a Tarp. <br />Names of responsible persons to be present in booth during all hours of operation: <br />| ptiniA 0hAVP7__________ <br />J <br />p-ee deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br />fon (one tablespoon of bleach per gallon of water). <br />-etergent, bleach, and wiping cloths (cleaning towels). <br />yb to store wiping cloths in bleach solution. <br />2.22.26 <br />Date <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 Water <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />iwner______ <br />Title <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420] F 209 464-0138 | www sicehd com <br />oJ)^6’02 Pa9° 8 of 11 TEMP EVENT APP <br />■. SAN JOAQUIN <br />1 ; ■; ------COUNTY <br />1 <or,1VY: Gifoiness j/rows Iteie. <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 />^iOchests Refrigerator <br /> Refrigerated truck Ice bath and tubs <br /> Other (specify)^_____________ <br />All food vendodrouthc are subject to inspection. Please make a copy of this application in <br />preparation y this evW A copy of this checklist must be in the booth at all hours of <br />■prefa^ration /nd operaticY^Return original to festival coordinator three weeks prior to <br />this ev^it. / \h