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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 />□ One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />□ Paper towels and pump-style soap container. <br />13. <br />14,Completed by: <br />Signature DateTitle <br />PaporHandTowols <br />Snap tfisponsor <br />Cullinp Board <br />BloachPropane Stove <br />Rinse Waler Bleach and Water <br />Fira Exlinnuishcr <br />•1l <br />Ice Cooler ! <br />lii <br />Soap and Water <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 />OJSub 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 />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 />Extra <br />Wator <br />5 Gal Hand wash <br />Waitowator Container <br />5-20 Gal. <br />Hand wash Water <br />Garbage <br />Can <br />Sanitizer bucket­ <br />bleach & vzalor for <br />staring wiping dclhs <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, ora Tarp. <br />Slorno w/Chafflng <br />Dish <br />SAN JOAQUIN <br />-~COUNTY...... <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 />S'ice chests Refrigerator <br />□ Refrigerated truck bath and tubs <br />□ Other (specify) <br />Extra Ice Bags & Food Containers must be K <br />stored 6 Inches off of the ground! S <br />JTSESSSESEEiEIiSZG <br />Health Permit |e <br />Propano Tank <br />**lmportant** <br />1868 E. Hazelton Avenue | Stockton. California 95205 | T 209 468-3420 | F 209 464-0138 [ www.sjgov.org/ehd <br />EHD 16-02 Page 8 of 11 TEMP EVENT APP <br />06/29/2023 <br />Names ofresponsible persons to be present in booth during all hours of operation: