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• V <br />Environmental Health Department <br />10. <br />for soapy water, one for rinsing and one for a bleach <br />12. <br />13.Names of responsible persons to be present in booth during all hours of operation: <br />Important* <br />14.Completed by: <br />Signature Title Date <br />Paper Hand Towels <br />Cutting Board <br />Propane Stove <br />IPropane Tank <br />Bleach and Water <br />Page 8 of 11 <br />Stemo w/Chaffing <br />Dish <br />Garbage <br />Can <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 />BGalHandwaah <br />Wastewater Container <br />5-20 Gal. <br />Hand wash Water <br />SAN JOAQUIN <br />------COUNTY <br />r~ <br />Extra Ice Bags & Food Containers must be <br />stored 6 inches off of the ground! <br />7 <br />Rinse Water <br />lam providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />7 <br />Soap and Water <br />EHD ?6^2 Haze,ton Avenue I Stockton, California 95205 I T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />07/01/2024 Pa0e 8 of 11 TEMP EVENT APP <br />1^- Fire Extinguisher/---7 <br />' Ice Cooler i <br />i——— <br />Health Permit <br /> Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br /> One separate tub (bucket or basin) for the collection of rinse/wastewater. <br /> Paper towels and pump-style soap container. <br /> Three deep tubs (basins 6-8 inches minimum), one <br />solution (one tablespoon of bleach per gallon of water). <br />LJ Detergent, bleach, and wiping cloths (cleaning towels). <br />LJ Tub to store wiping cloths in bleach solution. <br /> Ice chests Refrigerator <br /> Refrigerated truck |ce bath and tubs <br /> Other (specify) <br />Soap dispenser | <br />Bleach <br />3^0 <br />°r a? S Abject t0 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 />tgis event. ' ~~ -K--------------------- <br />11' aXeSaXTsInkK8™"thin b0°th 'he 8anitary cleanin9 °f food P^ration utensil <br />OR <br />Exira <br />Water