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Environmental Health Department <br />11. <br />OR <br />12. <br />13. <br />Completed by: 14. <br />Paper Hand Towels <br />Soap dispenser <br />Cutting Board <br />BleachPropane Stove <br />Propane Tank <br />Soap and Water Rmse Water <br />Fire Extinguisher <br />Ice Cooler <br />EHD 16-02 <br />06/19/19 <br />[3 Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot) <br />£3 One separate tub (bucket or basin) for the collection of rinse/wastewater <br />0 Paper towels and pump-style soap container. <br />I am providing the following for adequate hand washing facilities, but ‘ ?parate from utensil wash within my <br />booth: <br />Extra Ice Bags & Food Containers must be <br />stored 6 inches off of the ground! <br />Stem© w/Chaffing <br />Dish <br />Extra <br />Water <br />5 Gal Hand wash <br />Wastewater Container <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping cloths <br /> Booth must be on <br />Concrete, Asphalt. <br />Plywood, or a Tarp <br />5-20 Gal <br />Hand wash Water <br />:ion and^pt <br />'Signature <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^peration Return original to festival coordinator three weeks prior to <br /> <br />Title Date <br />Important** <br />COUNTY <br />“ Greatness grows here. <br />10. <br />■ ’—«■ <br />Garbage <br />Can <br />-SAN JOAudIN <br />------C O U N T Y—— <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 />Ice chests Refrigerator <br /> Refrigerated truck ® Ice bath and tubs <br /> Other (specify) <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />Three compartment sink. <br />0 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 />■0 Detergent, bleach, and wiping cloths (cleaning towels) <br />W Tub to store wiping cloths in bleach solution. <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />EU01CC2 Page 8 of 11 TEMP EVENT APP <br />Bleach and Water <br />Names of responsible persons to be present in booth during all hours of oporanon: <br />Health Permit