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.f <br /> SANAJOAQUIN <br /> Environmental Health Department <br /> (?F, COUNTY— <br /> ' �,,r Greatness grot:,s here. <br /> 10. 1 am providing the following cold temperature control for the cold holding of potentiality hazardous foods below <br /> 4fi'F(if food is used the following day, maintain below 41aF temperature): <br /> LJ <br /> !ce chests ❑Refrigerator <br /> Refrigerated truck JZIce bath and tubs <br /> ❑Other(specify) <br /> 11. 1 am providing the following Items within my booth for the sanitary cleaning of food preparation utensil <br /> ❑Three compartment sink. <br /> OR <br /> Three deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br /> sot ion(one tablespoon of bleach per gallon of water). <br /> Qatergent,bleach,and wiping cloths(cleaning towels). <br /> VO'rub to store wiping cloths in bleach solution, <br /> 12. 1 am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br /> booth: <br /> (Water supply dispenser with warm water at a minimum of 100°F(i.e.5-20 gallon container with spigot). <br /> VOne separate tub(bucket or basin)for the collection of rinselwastewater. <br /> VPapertowels and Pum"tvle soap container. <br /> 13. Names of responsible persons to be present in booth during all hours of operation: <br /> Yoeun Yan <br /> "*Important" 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. <br /> 14. Completed by: Yoeun Yan, Business Owner 11/14/2025 <br /> Signature I itle Date <br /> s-2o Gaff. <br /> Health Permit Sie Hand waslvk* <br /> mo�vh;heYng <br /> Osh <br /> Pap➢r Hand Tas�els <br /> 5aaA d!5➢CaS� <br /> Culllrr➢Board 5artlitter bucker• <br /> 01a><M&water la <br /> si➢dapx+{indatFo <br /> prepare Ssove Blench <br /> Booth must be on <br /> Concrete,Asphalt, <br /> F4vmd,or a Tarp. <br /> .- <br /> �A-,x�7 <br /> SorPMW%War R1nsaWaler PleachandWater Garbage <br /> FiraEwngtAsher can <br /> Extra <br /> ' 1NrrSef <br /> Ice Cooler sceirr,d, x, <br /> atiro ke Bags d Foad GOMaArars mar!be wosrecrater Corrtahrer <br /> slared6 hams a7afft CMMW <br /> 1868 E.Hazelton Avenue I Stockton,California 95205 T 209 468-34201 F 209 464-0138 j wvrw.sjcehd.com <br /> END 1602 Page a as 11 TUIP EVENT APP <br /> WW17 <br />