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Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br />13. <br />‘"Important** <br />14.Completed by: <br />Signature <br />Health Permit <br />Paper Hand l owols <br />Snnp dispenser <br />Culling Boord APropane Stovn Blench <br />0 <br />Prooano Tank <br />Rinse Water Blearii and Water <br />l-lre Exlinfiinsher <br />! Ice Cooler <br />Extra Ice Bags & Food Containers must be <br />storetl 6 inches off of the ground! <br />Extra <br />Water <br />5 Oal I land wash <br />Wastewater Container <br />6-70 Gal, <br />Hand wash Water <br />Garbage <br />Can <br />Sanitizer bucket­ <br />bleach A water for <br />slorinp wiping cloths <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp <br />Stereo w/Chnffing <br />. Dish <br />SAN JOAQUIN <br />’-COU NT Y— <br />_z <br />Soap and Water <br />□ Th^^pae^nTink temS b°°,h Clean'n9 °f ,0Od <br />Sn Wa,Sr' 3 <br />J^NDetergent. bleach, and wiping cloths (cleaning towels) <br />jxj'Tub to store wiping cloths in bleach solution. <br />^am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />1868 t. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 i www.sjgov.org/ehd <br />07/01 /2024 Page B of 11 TEMP EVENT APP <br />All food vendor booths are subject to inspection. Please make a copy of this application in <br />preparation for this evgnt. A copy of this checklist must be in the booth at all hours of <br />preparation and o»ergtioh. Return original to festival coordinator three weeks prior to <br />this event WCv-b / > 7~ ”777 7 - ----------______<-—- g> ha <br />Title Date <br />□ Ice chests Q Refrigerator <br />□ Refrigerated truck Q |ce bath and tubs <br />□ Other (specify) <br />^hWater supply dispenser with warm water at a minimum of 100’F (i.e. 5-20 gallon container with spigot). <br />S^pne separate tub (bucket, or basin) for the collection of rinse/wastewater. <br />j^Paper towels and pump-style soap container.