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SAN JOAQUIN <br />10. <br />11. <br />OR <br />12. <br />13. <br />“Important** <br />14. <br />Health Permit <br />Paper Hand Towels <br />Soap dispenser <br />Cutting Board <br />Propane Stove Bleach <br />c <br />0 <br />Propane Tank <br />Bleach and Water <br />Fire Extinguisher <br />Ice Cooler <br />Soap and Water <br />Exira Ice Bags & Food Containers must be <br />stored 6 inches off of the ground1 <br />Stemo w/Chaffing <br />Dish <br />Extra <br />Water <br />5 Gal Hand wash <br />Wastewater Container <br />5-20 Gal. <br />Hand wash Waler <br />Garbage <br />Can <br />Sanitizer bucket­ <br />bleach & water for <br />slonng wiping cloths <br />Booth must be on <br />Concrete, Asphalt. <br />Plywood, ora Tarp. <br />Date <br />- jo -in . StOCHOh 952G5 <br />EHD 16-02 <br />06/29/2023 <br />d?Go/7cx <br />Title <br />7 <br />Rinse Water <br />T 20--' 4C8-342C1 <br />Pags 8 of 11 <br />^Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />'^One separate 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 />J i) o-r\ Cc.rl o) / (A etrA a______________ <br />20<i .io4-013.1?- | wv/w Sj/fov ore./ihv: <br />TEMP EVENT APP <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />□ Three compartment sink. <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 />Jhis event. <br />Completed by: <br />Signature <br />^anr^providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />MThree 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 />LAL Detergent, bleach, and wiping cloths (cleaning towels). <br />Kl Tub to store wiping cloths in bleach solution. <br />I am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br />45OF (if food is used the following day, maintain below 41 °F temperature): <br />Ice chests Refrigerator <br />□ Refrigerated truck Ice bath and tubs <br />Q Other (specify)_