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J- ■p‘ .Environmental Health Department <br />i <br />11. <br />OR <br />12. <br />13. <br />Completed by: 14. <br />Paper Hand Towels <br />Soap dispenser <br />Cutting Board 3 BleachPropane Stovo <br />Bleach and Water <br />Q <br />Ice Cooler <br />Rinse Water <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 />Extra /co Bags & Food Contalnors must be <br />stored 6 Inches oil of the ground! <br />Extra <br />Water <br />5 Gal Hand wash <br />Wastowater Container <br />Garbage <br />Can <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping cloths <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, ora Tarp. <br />J2^Vater supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />00ne separate tub (bucket or basin) for the collection of rinse/wastewater. <br />4^fPaper towels and pump-style soap container. <br />Storno w/Chafflng <br />Dish <br />5-20 Gal. <br />Hand wash Water <br />di <br />Signature <br />Health Permit = <br />Propane Tank J <br />■ '•'J- <br />10. <br />SANJOAQUIN <br />------COUNTY------- <br />Greocness 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 />PTfoe chests 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 at all hours of <br />preparation and operation. Return original to festival coordinator three weeks prior to <br /> <br />Title Date <br />Soap and Water <br />j'-'i.v _ <br />Names of responsible persons to be present in booth during all hours of operation: <br />----------- -------------------------------------------------------------------------------------------- <br />Fira Extinguisher <br />**lmportant** <br />JCFThree 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 />JETDetergent, bleach, and wiping cloths (cleaning towels). <br />PTfub to store wiping cloths in bleach solution. <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