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<br />W1: <br />Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br />B Paper towels and pump-style soap container. <br />13. <br />Vsi Arc? <br />"Important** <br />14.Completed by: <br />Health Permit <br />Paper Hand TuwUs <br />Sdnp duponscf <br />BlanchPropnna S4rwo <br />•1 <br />(•u&W'u lar-r <br />Rinso Water <br />f L>UtKi<iWwr <br />aAV '*•In (M Hand waah <br />WaaUwMaior CnUmnar <br />Garbage <br />Can <br />Booth must be on <br />Concrete, Asphalt <br />Plywood, or o Tarp. <br />Slomo w/Cnallino <br />Dlth <br />bxlro <br />Water <br />SanJUzer buckel- <br />bloncti 4 vrator ’ar <br />atoring wiping dodia <br />Title <br />Ice Cooler ; i -j <br />, ..y' <br />_z <br />8<>op and Water <br />H Water supply dispenser with warm water at a minimum of 100T (i.e. 5-20 gallon container with spigot). <br />® One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />/-2- <br />Date <br />5-20 Gal <br />U.ind wash Waler <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. /) / s <br />Signature <br />SAN JOAQUIN <br />U * ------C OU N : Y - <br />Greotness grows here. <br />1 the followin9 001(1 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 Q Refrigerator <br /> Refrigerated truck Ice bath and tubs <br /> Other (specify)frj /A <br />lam providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />U Three compartment sink. <br />tdru tc» Btgi 4 Pood CorXMwn nmol Zm ■ <br />ttonn]0>u^o»olTottr>»Qmunll ■ <br />Names of responsible persons to be present in booth during all hours of operation: <br /> Vbi Arc <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within mv <br />booth: } <br />3 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 />B’Tub to store wiping cloths in bleach solution. <br />CutbriQ Board