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Environmental Health Department <br />10 <br />11 <br />OR <br />12 <br />minimum of 100T (i.e 5-20 gallon container with spigot). <br />13 <br />-Important** <br />Completed by: 14. <br />Health Permit <br />Paper Hand TqmmvH <br />Soap -Mrenwr <br />3 Bleacti <br /> <br />Pr >t*ar>c ’ark <br />Puge # ut 11 <br />preparation for this e/e/i|. A copy of this checklist must be in the booth at all hours of <br />preparation <br />this event. <br />5 Gai »Mr*4 waah <br />Cont.i»»«w <br />Garbage <br />Can <br />Slerno wvChaffirxj <br />San r jet txidiel <br />iftwlng wiping do^i <br />SANJOAOUIN <br />C O U N T <br /> <br />Soap and V/a^er <br /> _______ <br />Feit f- atv*<guisl’<ri <br />Booth musl be on I <br />Concrete. Asphalt <br />Plywood, or a Tarp <br />Owner <br />Title <br />SKI £5 <br />Dale <br />©Water supply dispenser with warm water at a <br />©One separate tub (bucket or basin) for the collection of nnseAvastewater <br />©Paper towels and pump-style soap container <br />1.■ ■ * . j, ■ <br />1 «.^?,n9 1116 fo,lowing co,d temperature control for the cold holding of potentially hazardous foods below <br />45 F (rf food Is used the following day. maintain below 41 “F temperature): <br />Mice chests ©Refrigerator <br /> Refrigerated truck ice bath and tubs <br /> Other (speafy) <br />Names of responsible persons to be present in booth during all hours of operation <br />Daniel Gonzalez <br />| Ice Cooler <br />f ice Sktgt 4 f txx# l*> ■ <br />6 t n’t at •fm ■ <br />©^nTr^comp,^rtiTC*0tMn^k'teniS W'^1'n d00^ ^or san'tery cleaning of food preparation utensil <br />©^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 />©(Detergent, bleach, and wiping cloths (cleaning towels) <br />M Tub to store wiping cloths in bleach solution. <br />1868 E Hazelton Avenue | Stockton, California 95205 | T 209 468 3420 1 F 209 464 0138 I www sjgov orq/eriri <br />EHO 16-02 Page 6 of 11 Ft MP I VI N1 AT-' <br />06/19.19 <br />i Prtfrdne StCWT <br />booth,he ^°*,ow’rk9 ter adequate hand washing facilities, but separate from utensil wash within my <br />Weach and Vi'Uci | <br />S-20 Ual <br />r- H4M <br />CUtinq Boa«<J j <br />X3z <br />All food vendor booths are subject to inspection Please make a copy of this application in <br />for this evert <br />Return original to festival coordinator three weeks prior to <br />Signature