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Environmentafi Health Department <br />10. <br />11. <br />OR <br />12. <br />El Water supply dispenser with warm water at a minimum of 100’F (i.e. 5-20 gallon container with spigot). <br />El One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />KJ Paper towels and pump-style soap container. <br />13. Names of responsible persons to be present in booth during all hours of operation: <br />14.Completed by: <br />Sm <br />FtfunKawfllFcMuA.- <br />ScopsKd Water BSwcfazcdWirter Wcrwi W.fe <br />Ice Cooler <br /> Cw> <br />bteadh&Kaatsrfcc <br />•asurg wfews dfcffiis <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />I am providing the following Items within my booth for the sanitary cleaning of food preparation utensil <br /> Three compartment sink. <br />S2D Gd. <br />ItadKastaU&fer <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />EHO 16-02 Page 8 of 11 TEMP EVENT APP <br />06/19/19 <br />S&sxo <br />lfc*> <br />SQdKnJioai!, <br />tttxdaKAer CaaSsmcr <br />Owner <br />Trite <br />Ekiotfi mssst be on <br />Concrete. Aspitaft. <br />Plywod, or a T»p. <br />SAN JOAQUIN <br />------COUNTY------ <br />C'fih/'nrjj iiroivi <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 41T temperature): <br />12 Ice chests Refrigerator <br />O Refrigerated truck Ice bath and tubs <br /> Other (specify) <br />Norma & David Muhlenbruch <br />‘‘Important4* <br />01/17/2024 <br />Date <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 operatmTlReturn original to festival coordinator three weeks prior to <br />this event x ///),f x <br />I PicpaaeTocA. <br />1: <br />Health Permit H <br />Q Three deep tubs (basins 6-8 inches mramumX one for soapy w^er, one for rinssng and one for a fcteach <br />solution (one tablespoon of bleach per gallon of water). <br /> Detergent, bleach, and wiping cloths (cleaning towels). <br /> Tub to store wiping cloths in bleach solution. <br />sSmastidsascSdgsessmB j <br />CM&gBcwd j