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9/24/25, 4:30 PM IMG_8594.jpeg <br />Environmental Health Department <br />10. <br />it. <br />OR <br />1Z <br />13. <br />**lmportanr* <br />this <br />14. Completed by: <br />Herth Permit <br />| aowdhpwmr <br />M»VM <br />Bitach <br />fr <br />[•otp and Water <br />Wra aanwuWw j <br />Ice Cooler <br />TEMP EVENT APPPaoesofll <br />https://mail.google.com/mail/u/3/#inbox/KtbxLvHHktzsVsXFwxktPvwbGQNGGzxzcg?projector=1&messagePartld=0.3 1/1 <br />I <br />Stems adChaflng <br />Pteh <br />BQolHandwMh <br />WaatewaterContalnar <br />MO Gd. <br />Hand Mth Water <br />Garbage <br />Can <br />SANJOAQUIN <br />" -----COUNTY-- <br />Grcc.'r. ;■ c; <br />0 <br />Title <br />/ <br />RbiaaWater [ | <br />0 <br />SmBteartoMM- I <br />btoafh&waterfcr I <br />teoringw^inctfctw | <br />/" 1 1 1 ■- <br />Booth must be on <br />Conciittt- Aiohnft <br />Ptywood,araTarp. <br />y-z^z^s- <br />Date <br />RU*? de®P (basins 6-8 Inches minimum), one for soapy water, one for rinsing and one for a bleach <br />swroon (one tablespoon or bleach per gallon of water). <br /> Determent, bleach, and wiping cloths (cleaning towels). <br /> TUb to store wiping cloths in bleach solution. <br />I^tmjyovkflnfl the following for adequate hand washing facilities, but separate from utensil wash within my <br />lampfovkflng the following Items within my booth for the sanitary cleaning of food preparation utensil <br />/®| Three compartment sink. <br />•v'" "• <br />:'5 U'L'' <br />I am providing the following cold temperature control for the cold holding of potentially hazardous foods bainw <br />45*F (ff food Is used the following day, maintain below 41 *F temperature): <br />(3 Ice chests Refrigerator <br /> Refrigerated truck Ice bath end tubs <br /> Other (specify) <br />Bteaoh and Water I <br />AH food vendor booths are subject to Inspection. Please make a copy of this appHcatkm In <br />preparation for this event A copy of this checklist must be In the booth at aB hours of <br />and operation. Return original to festival coordinator three weeks Prior to <br />I <br />ft <br />I <br />I <br />I I <br />! <br />Hgnature <br />------I <br />S??8«Haze,tonAv®nuol Stockton, Caltfomla 852051 T 208 488-34201 F 208404-0138 | www.sjgov.org/ehd <br />imMiwS PamSofll TSL“’“'E?rr-! <br />Water supply dispenser wfth warm water at a minimum of 100°F (l.e. 5-20 gallon container with spigot), <br />^pne separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Q f^per towels and Dumo-stvfe soap container. <br />Namsc of reeponsfole persons to be present In booth during all hours of operation: