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Environmental Health Department <br />11. <br />OR <br />12. <br />H 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 />S Paper towels and pump-style soap container. <br />13. <br />14.Completed by: <br />Health Permit <br />Paper Hand Towels <br />Soap dispenser <br />Cutting Board <br />Propane Stove Bleach <br />1 I <br />Propane Tank <br />Rinse Water <br />Fire Extinguisherfl <br />Ice Cooler S Gal Hand wash <br />Wastewater Container <br />Garbage <br />Can <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping cloths <br />Names of responsible persons to be present in booth during all hours of operation: <br />Jaspal Singh <br />Stemo w/Chaffing <br />Dish <br />Extra <br />Water <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />Extra Ico Bags & Food Containers must be <br />stored 6 Inches off of the ground! <br />SANJOAOUIN <br />------COUNTY------- <br />Greotness grows here. <br />I am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br />45°F (if food is used the following day, maintain below 41°F temperature): <br />[x] Ice chests Refrigerator <br /> Refrigerated truck Ice bath and tubs <br /> Other (specify)___ ______________________________________________________________ <br />Manager <br />Title <br />/ <br />Soap and Water <br />**lmportant**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 />this event 1 -/'■'izr I____c..kz- s <br />Signature <br />12??CA;Haze|t°nAvenuel Stockton, California 95205 | T 209 468-3420) F 209 464-0138 | www.sjgov.orq/ehd <br />07/0D1^4 Pa9e8Of11 TEMPE^NTAPP <br /> <br />09/24/2026 <br />Date <br />5-20 Gal. <br />Hand wash Water <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />■t .•copv?' <br />10. <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />)x] Three compartment sink. <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 />[x] Tub to store wiping cloths in bleach solution. <br />Bleach and Water |