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Environmental Health Department <br />10. <br />11. <br />OR <br />12 <br />towels and pump-style soap container. <br />13. <br />“Important* <br />Completed by: 14. <br />| <br />Paper Kwsd Towete <br />Soso drspef-wr <br />CvHinq Beard <br />Prepane Stove <br />0 <br />][So«: arxl W»tw <br />ice Cooler <br />TEMP EVENT APP <br />D <br />nj'Water supply dispenser with warm water at a minimum of 1OCTF (i.e. 5-2C gallon container with spigot), <br />[pd^rie separate tub (bucket or basin) for the collection of rinse/wastewater. <br />ex/ra B&gt fi Feed CofitoMers must <br />stared 6 inchtrf rfl of the Qn-jundf <br />cw <br />S--2Q Gai. <br />Hand waah Wafer <br />Garbage <br />Can <br />SanHicw bucket- <br />btoach & water fcr <br />-’ctrq-1 crc • <br />Sooth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />E^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 />Iptergenl, bleach, and wiping dull is (cleat ting towels). <br />ub to store wiping cloths in bleach solution. <br />Exira <br />Waler <br />WatUfcwaler Contamr <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <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 foltowing day, maintain betow4rF temperature): <br />[B*lce chests O Refrigerator <br /> Refrigerated truck S'tce bath and tubs <br />■Bother (specify^ <br />SAN JOAQUIN <br />COUNTY <br />aww* OKI 'AflB* <br />5Propane Tank <br />--------------------- <br />J Health Permit <br />1868 E. Hazelton Avenue I Stockton. California 95205 | T 209 468-3420 I F 209464-0138 | www.sjgov.org/ehd <br />EHO <4-02 Pas* • ef 11 tSS* a <br />08/19/19 <br />1 am providing toe following items within my booth for the sanitary cleaning of food preparation utensil <br />§2^hree compartment sink. <br />Names oi/psponable persons to be present in booth during all hours of operation: <br />_____ <br />'ah fcodvendor 'bootosare sui^'to inspBtion. 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 qperaiton. Retur <br />' Signature <br />Return original to festival coordinator three weeks prior to <br />Title