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Environmental Health Department <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 />H One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />H Paper towels and pump-style soap container. <br />Names of responsible persons to be present In booth during all hours of operation: <br />David Rainwater, Malra Rainwater, or designated representative <br />13. <br />“Important** <br />14. <br />Health Permit <br />P«p«rH«nd Towels <br />Bloacft <br />Propane Tank <br />DlescTi and Water <br />TEMP EVENT APP <br />Ir-rc-i <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 waler). <br /> Detergent, bleach, and wiping cloths (cleaning towels). <br /> Tub to store wiping cloths In bleach solution. <br />6Gil Hind with <br />WMMMMr Conu'ner <br />Garbage <br />Can <br />Sariilnr burktl- <br />UaichtHMrtor <br />ilodng wp'ng cloihi <br />Booth must ba on 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 />I am providing the following Items within my booth for the sanitary cleaning of food preparation utensil <br /> Three compartment sink. No1 Applicable - Not Serving Food. Pre-packaged food. <br />I <br />SoapindVrtler <br />biro «o B 031 i Foorj Comilncn rr,uu bo <br />olond S inchot on of Iho groord' <br />7 ' <br />| Rlm« Waler | <br />% <br />10. <br />>< ■ I__! Flro ExtlngUitwr I <br />(ice Cooler <br />1868 E. Hazelton Avenue I Stockton. California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjcehd.com <br />EHD 16-02 Puga 8 ol 11 TEMP EVEMT <br />07/3/17 <br />SAN JOAOUIN <br />■" 'j’l-.. ------COUNTY------- <br />Creotness grows 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 />0 Ice chests O Refrigerator <br /> Refrigerated truck Ice bath and tubs <br /> Other (specify) <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 al all hours of <br />preparation and operation. Return original to festival coordinator three weeks prior to <br />Completed bv: g)7/2.G <br />Signature Title Date <br />Soap dipor.lcr <br />Cuing tioaid <br />rropm Sim <br />SleniovzrCharrmo <br />Oilh