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Environmental Health Department <br />10. <br />12. <br />my <br />13. <br />“Important**All food vendor booths are subject to Inspection. Please make a copy of this application in <br />14.Completed by: <br />Ignature <br />Health Permit <br />Paper Hand Towel* <br />Propane Stove <br />Propane Tank <br />Rinse Water Bleach and Water <br />Ice Cooler ■ <br />Stemo w/Chaffing <br />Olah <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping cloths <br />Extra <br />Water <br />5 Gal Hand wash <br />Wastewater Container <br />Garbage <br />Can <br />SAN JOAQUIN <br />------COUNTY <br />5-20 Gal. <br />Hand wash Water <br />Owner <br />fitie <br />07/22/2025 <br />Date <br />J <br />Soap and Water <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />✓ <br />---- — <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 />this event _ <br />7 <br />C^/lce chests Q Refrigerator <br /> Refrigerated truck ice bath and tubs <br /> Other (specify) <br />Sluton S°aPy °ne f°r rin8in9 and f°r 8 b,each <br /> Detergent, bleach, and wiping cloths (cleaning towels). <br />LJ Tub to store wiping cloths In bleach solution. <br />NNaOf o^Yang3’616 persons t0 be Present ,n b00th durin9 al1 hours of operation: <br />1^- r Fire Extinguisher9^ <br />|,T — . <br />Extra /co Bags 4 Food Contahera must be <br />stored 6 Mies off of the ground! <br />1868 E. Hazelton Avenue I Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />EHD 16-02 Page 8 of 11 TEMP EVENT FPP <br />miMnnoa <br />11' {ZThree ram ^rt/ient^ink i16"18 With'n my b00th for the sanitary cleanin9 01 food Preparation utensil <br />OR 0 Sn ' <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within <br />UUUul. <br />S^Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />Q*One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Paper towels and pump-style sogp container. <br />Soap dispenser I <br />| Bleach L <br />BuO