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Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br />13. <br />14. <br />Signature <br />Health Permit <br />Paper Hand Towels <br />Soap dispenser <br />Cutting Board 3Propane Stove Bleach <br />Propane Tank <br />Rinse Water <br />Fire Extinguisher <br />Page 8 of 11 <br />Extra lea Bags & Food Containers must be <br />stored 6 inches off ot the ground! <br />Stemo w/Chaffing <br />Dish <br />5 Gal Hand wash <br />Wastewater Container <br />Garbage <br />Can <br />www.sjgov.org/ehd <br />TEMP EVENT APP <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 />Extra <br />Water <br />Ice Cooler <br />________F <br />SAN JOAQUIN <br />O U N T Y <br />my cleaning of food preparation utensil <br />Alexa Plate Taco <br />Title <br />All food vendor booths are <br />preparation for this event. <br />18b8 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 I F 209 464-0138 I <br />07OT26<S <br />H Water supply dispenser with warm water at a minimum of KOT (l.e. 5-20 gallon container with spigot). <br />El One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />H Paper towels and pump-style soap container. <br />05/02/25 <br />Date <br />5-20 Gal. <br />Hand wash Water <br />El Jion fone^ablespoon oyble^chXrn^f wa^6 006 °ne for 3 bteach <br />S Detergent, bleach, and wiping cloths (cleaning towels). <br />kJ Tub to store wiping cloths in bleach solution. <br />Names of responsible persons to be present in booth during all hours of operation: <br />Alejandro Garcia, Alexa Garcia, Maria Castellon <br />Bleach and Water <br />**lmportant**subject to inspection. Please make a copy of this application in <br /> <br />inis Gvent. <br />Completed by: Alejandro Garcia <br />but separate from utensil wash within myboothPr0Vidin^ thG f°ll0Wing for adecluate hand washing facilities, <br />I <br />Soap and Water I <br />H'ee chests 0 Refrigerator <br /> Refrigerated truck |Ce bath and tubs <br /> Other (specify),_______