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5-20 Gal <br />Hand wash Water <br />Cu ting Board <br />Soap dispenser <br />Propane Stove <br />Propane Tank <br />Soap and Water Garbage <br />Can <br />Stern° w/Chaffing <br />Dish <br />Health Permit <br />ann." Eifilar.uuiwia414iugarA; ' ' <br />Extra Ice Bags a Food Containers must be <br />stored 6 inches off of the ground! <br />5 Gal Hand wash <br />Wastewater Container <br />Paper Hand Towels <br />Sanitizer bucket- <br />bleach & water for <br />storing wiping cloths <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />SAN JOAQUIN <br /> <br />Environmental Health Department <br />COUNTY— <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 />[451.Ice chests Refrigerator <br />[I Refrigerated truck El Ice bath and tubs <br />[1] Other (specify) <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />CI Three compartment sink <br />iT <br />Three deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br />tion (one tablespoon of bleach per gallon of water). <br />Detergent, bleach, and wiping cloths (cleaning towels). <br />ub 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 />qOne separate tub (bucket or basin) for the collection of rinse/wastewater. <br />.g Paper towels and pump-style soap container. <br />Names of responsible persons to be present in booth during all hours of operation: <br />16126 QV „1-0 1,4 J 6 1-15,4, rA.rz& 5 rEttiovr <br />**Important** 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. Re urn original to festival coordinator three weeks prior to <br />this eVnt. <br />Completed by: ia-44-1 (5 (i&siP 411-21 <br />Signature Title Date <br />1868 E. Hazelton Avenue 1 Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 I www.sjgov.org/ehd <br />END 16-02 Page 8 of 11 TEMP EVENT APP <br />06/29/2023 <br />OR