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Environmental Health Department <br />w <br />11. <br />OR <br />12. <br />E Water supply dispenser with warm water at a minimum of 100’F (i.e. 5-20 gaJlon container wtfi spigot) <br /> One separate tub (bucket or basin) for the collection of rinseAvastewater. <br /> Paper towels and pump-style soap container. <br />13. <br />"Important” <br />14. <br />Health Permit <br />F <br />I <br />C <br />‘ f: <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />E Three compartment sink. <br />Names of responsible persons to be present in booth during all hours of operation: <br />Jerry Hill <br />K*cr 4 ter <br />Bccth rr t-s on <br />Concede -.scriT. <br />P ex □ Tarr- <br />I am providing the following cold temperature control for the cold holding of potentially hazardous fooris h-elu/. <br />45’F (rf food is used the following day, maintain below 4IT temperature) <br />Q Ice chests Q Refrigerator <br />Q Refrigerated truck Q Ice bath and tubs <br />O Other (specify) <br />: Ice Cooler <br />I am provxhng the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />Sitrra •Ourtn; <br />SAN JOAQUIN <br />■ -COUNTY-— <br />iwMCBWwr/ww- <br />•• ! <br />Manager <br />Title <br />IT <br />_Z <br />~j.>' r-' <br />AU 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. Return original to festival coordinator three weeks prior to <br />this event <br />Completed by: Kristopher Moyer <br />Signature <br />7/20/2025 <br />Date <br /> Three deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br />solution (one table spoon of bleach per gallon of water) <br />|_| Detergent, bleach, and wiping cloths (cleaning towels). <br /> Tub to store wiping cloths in bleach solution <br />trt <br />f StiXAtcn CaMcrma 95205 | T 209 468-3420 | F uL'v 4<:4 > ■ <br />b cl 11 <br />I tZ3 I LI <br />wat-