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Environmental Health Department <br />12. <br />‘aper towels and pump-style soap container. <br />13. <br />**lmportant** <br />’ Datf? <br />14.Completed by: <br />Date <br />Health Permit <br />Paper Hand Towels <br />Soap dispenser <br />Culling Board <br />Propane Stove Bleach <br />r7 \Propane Tank <br />Fire txbnguisher <br />4 <br />TEMP EVENT APP <br />Extra /co Bags & Food Containers mist be <br />stored 6 inches otfofthe ground! <br />Extra <br />Water <br />5 Qol Mend wash <br />Wastewaler Container <br />Garbage <br />Can <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping cloths <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, ora Tarp. <br />Stomo w/Chaffng <br />Dish <br />5-20 Gal. <br />Hand v/ash Water <br />0 <br />Ice Cooler <br />________7 <br />N^qtes^of^respop^iblle f?erson^to be present in booth during all hours of operation: <br />4^0^ <br />rfL <br />Soap and Waler Rinse Water <br />itiorr- Return ori <br />Signature <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sicehd.com <br />OtSi?^2 Pago 8 of 11 TEMP EVEN! <br />SAN J OAOUIN <br />f —C O U N T Y— <br />c / -s':ior.-jv^'5' Crcolness t/rotvs here. <br />10. I am providing (he following cold temperature control for the cold holding of potentially hazardous foods below <br />A5 F (if food is used the following day, maintain below 41 °F temperature): <br />p4ce chests Refrigerator <br /> Refrigerated truck Ice bath and tubs <br /> Other (specify) <br />1?t;^)J^iprovic,ing the fo,lowin9 ilems within nV booth for the sanitary cleaning of food preparation utensil <br />\b -•wThree compartment sink. <br />OR / <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 /> 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 />prep^attorband operations Return original to festival coordinator three weeks prior toL v IWV <br />Title <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within mv <br />booth: 7 <br />.xHV^ter supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />^0One separate tub (bucket or basin) for the collection of rinse/wastewater.