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Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />_ -4 <br /> <br />SAN4JOAQUIN <br /> <br />Environmental Health Department <br />COUNTY <br />L. <br />0 17- ureatness grows here <br />-a Ice chests 0 Refrigerator <br />Refrigerated truck fake bath and tubs <br />Other (specify) <br /> <br />11. I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />Three compartment sink. <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 />ScDetergent, bleach, and wiping cloths (cleaning towels). <br />iNvTub to store wiping cloths in bleach solution. <br />12. 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 />One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Paper towels and pump-style soap container. <br /> <br />13. Names of responsible persons to be present in booth during all hours of operation: <br />S 15Avk <br />OR <br />Cutting Board <br />Propane Stove <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 opejation. Return original to festival coordinator three weeks prior to <br />this even <br />ci <br />Signature Title <br />5-20 Gal. <br />Hand wash Water <br />Paper Hand Towels <br />Soap dispenser <br />Sanitizer bucket- <br />bleach &water for <br />storing wiping cloths <br />**lm portant** <br />14. Completed by: <br />Health Permit <br />54,ui 9 • 2S--- 2- ti <br />Date <br />Sterpo w/Chaffing <br />Dish <br />Garbage <br />Can <br />Fire Extinguisher <br />Extra Ice Bags & Food Containers most be <br />stored 6 Inches off of the ground! <br />5 Gal Hand wash <br />Wastewater Container <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sjgov.org/ehd <br />EHD 16-02 Page 8 of 11 TEMP EVENT APP <br />06/29/2023