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Environmental Health Department <br />^6.', <br />10. <br />11. <br />OR <br />12. <br />K 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 />KI Paper towels and pump-style soap container. <br />13.Names of responsible persons to be present in booth during all hours of operation: <br />14.Completed by: <br />Health Permit <br />Papal Hand l owaia <br />Soep dteponser <br />Cutting Board <br />BleachPropene Stove <br />-X. 7. <br />Rre Extinguisher <br />Ice Cooler <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <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 evenL- i I i . VS <br />Starno w/Chafflng <br />DW) <br />5-20 Gal. <br />Hand wash Water <br /> Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />5 Gal Hnrd wash <br />Wastawster Container <br />Garbage <br />Can <br />Sanltizor buckel- <br />btoech & waler for <br />eloring wiping cloths <br />Extra <br />Water <br />Linh Ha <br />‘‘Important** <br />Manager <br />Title <br />9/5/19 <br />Date <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 />Propane Tank I -I <br />r - ' i <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> Three compartment sink. <br />KI 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 />K Detergent, bleach, and wiping cloths (cleaning towels). <br />KI Tub to store wiping ctoths In bleach solution. <br />_ Ji J a <br />■ \ SANJOMUIN <br />'■ -----COUNTY------ <br />Greotness 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 />K Ice chests Refrigerator <br /> Refrigerated truck KI Ice bath and tubs <br /> Other (specify) <br />Exbv Ico Bags A f:ood Containers must be m <br />stored 8 tnchos off of the ground! H <br />Soap and Water Rlrwe Water