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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 />O Paper towels and pump-style soap container. <br />13. <br />“Important** <br />14.Completed by: <br />Health Permit <br />Papor Hand Towels <br />Soap dispenser <br />Propano Stove <br />LT ^ju <br />Fira Fxllnoulshei <br />Ice Cooler <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 />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> Three compartment sink. <br />Slamow/Chaltlng <br />Dish <br />Exira <br />Walar <br />5 Gal Hand wash <br />Waslewater Conla'nor <br />Garbage <br />Can <br />Sanllliar buckal- <br />bloach a waler for <br />alodng wiping cloths <br />Booth must bo on <br />Concrete, Asphalt, <br />Plywood, ora Tarp. <br />r,’|- <br />Title <br />j 2 - - <br />Extra lea Bags & Foor) Containers must bo <br />stored 6 Inches ollotlho groundl <br />'i <br />10. <br />SANJOAOUIN <br />------COUNTY------- <br />Greatness j/r (»•.?•• Ik-k. <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 />I _z <br />Rlnso Water <br />E <br />Soap and Water <br />I Culling Board <br />ee weeks prior to <br />Date <br />Names of responsible persons to be present in booth during all hours of operation: <br /> <br />All food vendor booths^re 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 />preparatiola and operation. Return original to festival coordinator three <br /> <br />\ Signature <br />Propana Tank <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420) F 209 464-0138 | www.sjcehd.com <br />EHD 16 02 Page 8 of 11 TEMP EVENT APP <br />07/3/17 <br />5-20 Gal. <br />r- Hand waih Water <br />Soap dispenser ---------- \ <br />I Bleach <br />Bleach and Water