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mi—io u jui; <br />Environmental Health Department <br />10. <br />11. <br />OR for rinsing and one for a bleach <br />12. <br />Paper towels and pump-style soap container. <br />Names of responsible persons to be present in booth during all hours of operation:13. <br />‘‘Important** <br />14. <br />Health Permit <br />Paper Hand Tomeis <br />Soap dispenser <br />BleachPropane Stove <br />czd i <br />Propane Tank <br />Fire Extinguislier <br />Page 8 ol 11 <br />I)a <br />Rinse Waler <br />Extra Ice Bags & Food Containers must be <br />stored 6 indies off of the ground! <br />Sterno w/Chafting <br />Dish <br />Extra <br />Water <br />5 Gal Hand wash <br />Woslewator Container <br />Garbage <br />Can <br />Sanitizer bucket' <br />bleach & water for <br />storing wiping doths <br />Booth must be on <br />Concrete, Asphalt. <br />Plywood, or a Tarp. <br />1868 E. <br />EHD 16-02 <br />06/29/2023 <br />5-20 Gal. <br />Hand wash Waler <br />Ice Cooler <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> Three compartment sink. <br />Q.Three deep tubs (basins 6-8 inches minimum), one for soapy water, one <br />Solution (one tablespoon of bleach per gallon of water). <br />Q Detergent, bleach, and wiping cloths (cleaning towels). <br />Si Tub 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 />Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />[Tj One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />Page8ol11 TEMP EVENT APP <br />SAN JOAQUIN <br />------COUNTY------- <br />. . ■ Crrc.’n.'SS Qroitt hc.'C <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 />l/i Ice chests Refrigerator <br /> Refrigerated truck Ice bath and tubs <br /> Other (specify)__ _________—---------------------------------------------------------------- <br />r this everjt. A. copy of this checklist must be in the booth at all hours of <br />id operation Return original to festival coordinator three weeks prior to <br />Signature Title Date ’ <br />Soap and Waler j 'll <br />All food vendor booths ar^ subject to inspection. Please make a copy of this application in <br />preparation for this evei ‘ <br />preparation ani’ <br />this event. ’ <br />Completed by: <br />Cutting Board