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Environmental Health Department <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 /> One separate tub (bucket or basin) for the collection of rinse/wastewater. <br /> Paper towels and pump-style soap container. <br />13. <br />**lmpprtant** <br />Completed by: 14. <br />Date <br />Pnpor Hand Tovzels <br />Soap (Espcfiser---------- <br />Cultino Board <br />Propane Stova <br /> PmpanoTnhk <br />A Firo Fxlingulshor <br />Ice Cooler <br />TEMP EVENT APPPage 8 of 11 <br />Un <br />£ <br />Soap end Waler <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />Garbage <br />Can <br />Booth must be on <br />" Concrete, Asphalt, <br />Plywood, or a 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 Col. <br />I land wash Waler <br />'w;: *. <br />■••r Alr I,, <br />10. <br />| Health Permit [I <br />L\ <br />SarWrcrbuckel- bleach & waler for <br />storing wiping cloths <br />I <br />1868 E. Hazelton Avenue) Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjcehd.com <br />EHp 16-02 Page 8 of 11 TEMP EVENT <br />07/3/17 <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 />Extra Ice Baos & Food Containers must be <br />stored 6 Inches otto!Ilin ground! <br />flames of responsible persons to be present in booth during all hours of operation: <br />^■31- ________________ <br />5 Gal Hand wash <br />WHstawnlor Coriialrw <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 />this event. <br /> <br />Signature k"' Title <br />Bleach and Watar j | <br />SANJOAOUIN <br />K? ------COUNTY— <br />./ <br />Greotness i/ioivs 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 /> Ice chests Refrigerator <br /> Refrigerated truck Ice bath and tubs <br /> Other (specify) <br />Slomow/chaffing _ <br />I Dish