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Health Permit <br />Cutting Board <br />Soap aria Wolof <br />I <br />8 aaltizer buckel• <br />Month Sw5lot tAr <br />;Wino iffiphisi &Ms <br />Booth must boon <br />Concrete, Asphalt, <br />Plywood, or a Tarp, <br />SAN ,JOAQUIN <br />—COUNTY— \ <br />' Gruotne” <br />REC-008 <br />Environmental Health Department <br />10, I am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br />4Ic <br />5°F (II food Is used the followln , maintain below 41°F temperature): <br />e chests Refrigerator <br />efrigerated truck Ice bath and tubs <br />ther (specify) <br />11. Lomji providing the following Items within my booth for the sanitary cleaning of food preparation utensil <br />V three compartment sink. <br />OR —47 <br />nylon (one tablespoon of bleach per gallon of water). <br />I poetergent, bleach, and wiping cloths (cleaning towels). <br />Three deep tubs (basins 6-8 Inches minimum), one for soapy water, one for rinsing and one for a bleach <br />ruble 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 />riNater supply dispenser with warm wafer at a minimum of 100°F (1,e, 5-20 gallon container with spigot), <br />ne separate tub (bucket or basin) for the collection of rinse/wastewater. <br />!----tapor towels and pump-style soap container. <br />Names of responsible persons to be present In booth during all hours of operation: <br />JASPREET OUR PADAM <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 ol this checklist must be In the booth at all hours of <br />preparation and operation„Relum original to festival coordinator three weeks prior to <br />this event. <br />Completed by: <br /> <br />OWNER <br />Signature <br />04/22/2024 BMI <br />Title Dale <br />iloe Cooler <br />Ptepsna slava <br />Dam Ica flogs 6 Food coalahata mini bet <br />Voted Cloches oil 61 Ma wound, <br />Ntataa w/Chalrof <br />Dish <br />FIni Wet& <br />41101 -1-111 <br />Oat Orli wish <br />WAS tewaler Colt Aitla f <br />Soap aspaasor <br />Misch <br />Manch nail %Armor <br />5.20 GaL <br />Hand wash Wahl( <br />Owings <br />Gun <br />paper HaM Tareols <br />1868 E. Flazelion Avenue I Stockton, California 95205 1 209 468-3420 I F 209 464-0138 I WWW.SjgOV.Orgiehd <br />El-{D 16.02 Page 8 ol 11 TEMP EVENT APP <br />08/1D/19