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foods below <br />11. <br />OR <br />for rinsing and <br />12. <br />13. <br />14.Completed by: <br />Paper Hand Towels <br />Soap dispenser <br />Cutting Board <br />BleachPropane Stove <br />Propane Tank <br />Soap and Water Rinse Water Bleach and Water <br />Fire Extinguisher <br />209 464-0138 1 Www-sigov.org/ehd <br /> TFUn ___ <br />Garbage <br />Can <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping cloths <br />Stemo w/Chaffing <br />Dish <br />5-20 Gal. <br />Hand wash Water <br />Extra <br />Water <br />| Ice Cooler <br />container with spigot). <br />| Health Permit <br />Environmental Health Department <br />I am |— ■■ <br />45°F (if food is <br />^.Ice chests <br />®Pefrigerated truck <br />□ Other (specify) <br />I <br />'S'- ' <br />10. <br />Title <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. <br />Signature <br />**lmportant** <br />5 Gal Hand wash <br />Wastewater Container <br />SANjJOAQUIN <br />COUNTY-—- <br />rov0-00^6” 9r°nS here- <br />used the^olb^n®T?eratu.re control for the cold holding of potentially hazardous <br />9 oay. maintain below 41 °F temperature): <br />Q Refrigerator <br />Q Ice bath and tubs <br />I Extra Ice Bags i Food Containers must be I <br />stored 6 Inches off of the ground! ■ <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3470 i c <br />EHD 16-02 Page 3 of 11 I <br />06/19/19 <br />O^Three compartment^fok.ltemS my booth for the sanitary cleaning of food preparation utensil <br />2'^^^ minimum), one for soapy water, one for rinsing and one for a b.each <br />□ Detergent, bleach a^d wiS .Per gal,on of water>- <br />□ Tub to store wiping cloths in bfotch sKfom09 <br />> am^providing the folfowing for adequate hand washing facilities, but separate from utensil wash within my <br />Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon <br />K, parate tub (bucket or basin) for the collection of rinse/wastewater. <br />^Paper towels and pump-style soap container. <br />Names of responsible persons to be present in booth during all hours of operation: <br />__&yQY\rkrL <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp.