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Environmental Health Department <br />10. <br />11. <br />OR <br />I <br />12. <br />I <br />Completed by:14. <br />Health Permit <br /> Paper Hand Towels <br />Soap dispenser <br />Cutttnq Boaid <br />BleachPropane Stove <br />f <br />Propane Tank <br />Fire ExUnpiasher <br />I <br />Ice Cooler <br />Page 8 of 11 <br />■M <br />I <br />Soap and Water <br />EHD 16-02 <br />06/19/19 <br /> One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Qfpaper towels and pump-style soap container. <br />Slemo vtfChaffing <br />Deh <br />5 Gai Hand wash <br />Wastewater Container <br />5-20 Gal <br />Hand wash Water <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping cloths <br />Ms <br />IM. <br />Signature <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />z__ <br />Rmae Wattr <br />f -r- ,SANJOAQUIN <br />------COUNTY------- <br />Greotnejs 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 />OTlce chests Refrigerator <br />O 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 />------------------------\ <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, ora Tarp <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 />this event A ... <br />CFO______ <br />Title bate <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 I F 209 464-0138 | www.sjgov.org/ehd <br />Page 8 of 11 TEMP EVENT APP <br />Garbage <br />Can <br />13 Hennes oRes^nsibte persons to be p^resent^in^booth duri^aHhoursof operation. <br />“Important** <br />Extm kx Bags & Food Contanors muaf bo I <br />stoobd 6 inches off of the ground’ r <br />EJ 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 /> Detergent, bleach, and wiping cloths (cleaning towels). <br />EJ Tub to store wiping cloths in bleach solution. <br />J '