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Environmental Health Department <br />10. <br />2S>°ape' towels and pump-style soap container. <br />Completed by <br />ignature Date <br />Health Permit <br />~l Paper Hanc '■ 2wels <br />Scap dispense. <br />Cu'tirn board <br />jpt-t Tenv <br />Bleach ana WalerSoap anc Vvaier Rinse Wale.’ <br />Ice Cooler <br />J <br />I <br />O^Vater supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />'a separate tub (bucket or basin) for the collection of rinse/wastewater. <br />5 Gal Hana wash <br />Wastewftwr Container <br />5-20 Gai <br />Hand wasn Water <br />Flip 1G-02 <br />06 ib'iq <br />Stemc <br />Disn <br />i am providing the following for adequate hand washing facilities, but separate from utensii wash within my <br />booth' <br />Sanitizer pucaoI- <br />o.eacn i water 'or <br />a;ar.,u <v,c.rg ccths <br />SAN JOAQUIN <br />-county -... <br />Al! food vendor booths are subject to inspection. Please make a copy of this application <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 (.-> <br />this event. <br />(X- <br />Title <br />mri Avenue . Sim'.kton California 95205 | T 209 468-3420 | F 209 464-0138 | www sjyov org/elid <br />Page 8 of 11 TEMP EVE NT APP <br />Booth must oe on <br />Concrete Asphalt, <br />i Plywood, or a Tarp. <br />' i t'.ra t/jgs i f coo Coidjnen u,us1be <br />i tre-td/f' ■ cf'ie'j (jfftjf the (Aindi <br />\ames of responsible persons to be present in booth during all hours of operation: <br />' *din<? ,he following cold temperature control for the cold holding of ootentially hazardous foods below <br />4b t- (if food is used the following day, maintain below 41 °F temperature): <br />Sjce chests p| Refrigerator <br /> Refrigerated truck Q ice bath and tubs <br /> Other (specify) ________ <br />*'lmportant*> <br />i ’-ropi:' K <br />I <br />Exua <br />Wdrtei <br />i 4iii providing tine following items within my booth for tne sanitary cleaning of food preparation utensii <br />T^syiree compartment sink. <br />ISJhree 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 />(SsDetergent, bleach, and wiping cloths (cleaning towels). <br />L_i Tub to store wiping cloths in bleach solution. <br />Garbage | <br />Can <br />Bleach