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Environmental Health Department <br />11. <br />OR <br />soli <br />12. <br />Paper towels and pump-style soap container. <br />13.Names of responsible persons to be present in booth during all hours of operation: <br />Return <br />14.Completed by: <br />Health Permit j <br />Paper Hand Towels <br />Propane Stove <br />Soap and Water Rinse Water Bleadn and Water <br />Fra Extinouiahar <br />Page 8 of 11 <br />Stemo w/Chaffing <br />Dish <br />Extra <br />Water <br />Garbage <br />Can <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />5 Ga| Hand wash <br />Wastewater Container <br />6-20 Gal. <br />Hand wash Water <br />Sanitizer bucket- <br />Haach & water for <br />storinQ wiping doths <br />Ice Cooler <br />1g nature <br />“Important** <br />Propane Tank <br />V <br />10. <br />BvVater supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />E*One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Three deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br />ption (one tablespoon of bleach per gallon of water). <br />Petergent, bleach, and wiping doths (cleaning towels). <br />Tub to store wiping cloths in bleach solution. <br />lam providing the following items within my booth for the sanitary deaning of food preparation utensil <br />LI Three compartment sink. <br />Extra Ice Bagtt, Food Containers must be I <br />’’ stored S inches off at the ground! I <br />l?“M2HaZeltOnAVenUe| stockton' California 95205 | T 209 458-3420 | F 209 464-0138 | www.sjcehd.com <br />07/3/17 Page 8 of 11 TEMP EVENT APP <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 operatjoiL^ Return original to festival coordinator three weeks prior to <br />this evagws a j /] _ ~ ------ <br />Title |Date <br />l*ar^providing the following for adequate hand washing fadlities, but separate from utensil wash within my <br />% SANJOAOUIN <br />"T •----- <br />I am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br />45T (if food is used the following day, maintain below 41 °F temperature): <br />Eice chests Refrigerator <br /> Refrigerated truck Ice bath and tubs <br /> Other (specify)__________ <br />Soap dispenser