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Environmental Health Department <br />10. <br />12. <br />my <br />O Paper towels and pump-style soap container. <br />13. <br />14.Completed by: <br />Date <br />Health Permit <br />Paper Hand Towala <br />Propane Stove <br />IEPropane Tank <br />Rinse Water Bleach and Water <br />Stemo w/Chaffing <br />Dish <br />5-20 Gal. <br />Hand wash Water <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 />5 Gal Hand wash <br />Wastewater Container <br />Garbage <br />Can <br />SAN JOAQUIN <br />------COUNTY <br />^jVater 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 />Extra Ice Bags & Food Containers must be I <br />stored fl inches off of the ground! <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />n7/ni «no4 Pa9B 8 of 11 TEMP EVENT APR <br />I <br />Soap and Water <br />Namj8an^erile^rr31s^^1TeTSbti?Tdurin9 a,i hours of operation: <br />“Important** <br />5Ce chests Refrigerator <br />1J Refrigerated truck Q Ice bath and tubs <br /> Other (specify) <br />eni^n Md0e*PMUbS ^basi^16"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 />i providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />i nree compartment sink. <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within <br />booth: <br />/-N I Fire ExtinguisherJrIce Cooler <br />Soap dispenser __ <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 and operation. Return original to festival coordinator three weeks prior to <br /> rwliK, Owner 8/12/25 <br />Signature1 Title <br />Cutting Board