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i <br />Environmental Health Department <br />10. <br />11. <br />OR <br />12.my <br />^Q'Paper towels and pump-style soap container. <br />13.Names of responsible persons to be present in booth during all hours of operation: <br /> <br />14.Completed by: <br />Signature <br />Health Permit <br />Paper Hand Towels <br />Soap dispenser <br />Cutting Board <br />1Propane Stove Bleach <br />10a:nT <br />Propane Tank <br />Rinse Water Bleach and Water <br />EHD 16-02 <br />07/01/2024 <br />Sterno w/Chaffing <br />Dish <br />3 Gal Hand wash <br />Wastewater Container <br />Garbage <br />Can <br />Sanitizer bucket­ <br />bleach 8 water for <br />storing wiping cloths <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />SAN JOAQUIN <br />-COUNTY------ <br />( Extra ' <br />I Water <br />Extra Ice Bags & Food Containers must be <br />stored 6 inches off of the ground! <br />Important** <br />z <br />Soap and Water <br />5-20 Gal. <br />Hand wash Water <br />Ice Cooler <br />_______lz <br />All 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 an^o^grgtiorC Return original to festival coordinator three weeks prior to <br />this event^<>X_ _ <br /> <br />Title 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 tablespoon of bleach per gallon of water). <br /> Detergent, bleach, and wiping cloths (cleaning towels). <br /> Tub to store wiping cloths in bleach solution. <br />^3^/ater 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 />^0 Ice chests Q Refrigerator <br /> Refrigerated truck |Ce bath and tubs <br /> Other (specify) <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within <br />booth: <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />CUr' ■’C Page 8 of 11 TEMP EVENT APP <br />I Fire Extinguisher <br /> Three compartment^hk San'tary cleanin9 of food Preparation utensil