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Environmental Health Department <br />10. <br />utensil <br />12. <br />13. <br />14.Completed by: <br />Health Permit <br />Paper Hand Towels <br />Soap dispenser <br />Cutting Board <br />Propane Stove Bleach <br />Propane Tank <br />Fire Extinguisher <br />Ice Cooler <br />Stemo w/Chaffing <br />Dish <br />5 Gal Hand wash <br />Wastewater Container <br />5-20 Gal. <br />Hand wash Water <br />Sanitizer buckot- <br />bteach & water for <br />storing wiping cloths <br />Extra <br />Water <br /> Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />Q One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />O Paper towels and pump-style soap container. <br />Soap and Water Rinse Water <br />11 □^hr^oompartmeT'0 k 'temS Sanitary cleanin9 of food preparation <br />OR <br />^providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />“Important* <br />TuS Pedrazale P6^005 tO be present in durin9 al1 hours of operation: <br />■ <br />Greatness grows here, <br />■ 1 «.pc^ the fo“°yvin9 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 />C] Ice chests Q Refrigerator <br /> Refrigerated truck Ice bath and tubs <br /> Other (specify) <br />Garbage <br />Can <br /> Three compartment sink. <br />Pluton for S°3PV Water' One rinSlnS and °"e for a bteach <br /> Detergent, bleach, and wiping cloths (cleaning towels). <br /> Tub to store wiping cloths in bleach solution. <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a 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. -------------- -------- <br />______Owner <br />Signature Title <br />Extra ice Bags & Food Containers must be <br />———stored 6 inches off of the ground1 t <br />Ha2elt°n A''enUe I S,0I*,0n' Ca“'ornia 95205 | T 209 468-34201 F 209 464-0138 | vmw.sjgov.org/ehc <br />06/19/19 Pa9e 0 d 11 TEMP EVENT APP <br />SANJOAOUIN <br />------COUNTY------