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Environmental Health Department <br />11. <br />OR <br />12. <br />0 Water supply dispenser with warm water at a minimum of 100T (i.e. 5-20 gallon container with spigot). <br />13. <br />Completed by: 14. <br />nature <br />1 PaparHnnd Towels <br />Soap cSspenaer <br />Cdtinn Board <br />BlenchPropane Stcwo <br />‘IPropane Tank <br />Blanch and WalerRkrso WalerSoap ond Water <br />Rre Exilnaulsher <br />TEMP EVENT APRPage a of 11 <br />ir/< <br />•aiL <br />Exira <br />Walnr <br />Garbage <br />Can <br />Sontltar bucket- <br />bleach & waler Car <br />staring wiping dolhs <br />Stoma w/Chalfing <br />Dish <br />5 Gal Hand wash <br />WasiBvmler Container <br />5-20 Gal. <br />Hand wash Water <br />Extm fco flags 4 Focrf Ctmtehors must bo <br />slanui 6 fnebas utter tho Dtuundl <br />w•We <br />1368 E. Hazelton Avenue I Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgavmrg/ehd <br />EHD 16.02 Page B of 11 TEMP EVENT Al <br />06/19/10 <br />f=muT?T-1 <br />Health Permit <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 />Ivflce chests Refrigerator <br /> Refrigerated truck Ice bath and tubs <br /> Other (specify)___—-----------------------------------------------—----------- <br />----------------------1^ <br />Ice Cooler y y <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 />4/h/t > <br />Title Date <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> Three compartment sink. <br />(H'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 />[vfTub to store wiping cloths in bleach solution. <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />fl/f One separate tub (bucket or basin) for the collection of rinse/waslewater. <br />^Paper towels and pump-style soap container. <br />Names of responsible persons to be present in booth during all hours of operation: <br />Toh cut AitoXMM C ycttct rx i iz-e. <br />**lmportant** <br />SAN JOAQUIN <br />. -----C O U N T Y------ <br />Greatnc^f /jrnws har^. <br />10. <br />•—■“ x <br />Boolh must be on <br /> Concrete, Asphalt, <br /> Plywood, or a Tarp.