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Docusign Envelope ID: 3FCBD705-CB30-43D4-AD6B-B0E07677700C <br />REC-008 <br />Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br />Q 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 />Q Paper towels and pump-style soap container. <br />13. <br />“Important" <br />07-19-2024 <br />Completed by:14. <br />Title Date <br />Paper Hand Towels <br />Cuttinq Board <br />Propane Sieve <br />Propane Tank <br />Ice Cooler <br />this event. <br />Names of responsible persons to be present in booth during all hours of operation: <br />alma pineda, ryan carter <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> Three compartment sink. <br />Sterno w.’Chalhng <br />Dish <br />Garbage <br />Can <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping cloths <br />Q 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 />Q Detergent, bleach, and wiping cloths (cleaning towels). <br />Q Tub to store wiping cloths in bleach solution. <br />5-20 Gal. <br />Hand washWater <br />Booth must be on <br />Concrete, Asphalt. <br />Plywood, ora Tarp. <br />SAN JOAQUIN <br />------COUNTY------- <br />Greatness 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 />Q Ice chests Refrigerator <br /> Refrigerated truck Q” Ice bath and tubs <br /> Other (specify) <br />4^ <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 />•Signed vt« £*aml«>asOoc«.c0m <br />I Key;7dcSc7B»-5&l»i463f»n5l<i:ffd2b91e<oigiiaiui c <br />| Health Permit | <br />1868 E. Hazelton Avenue | 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 APP <br />06/19/19 <br />Soap dispenser <br />Bleach <br />Rinse Water Bleach and WaterSoap and Water <br />Fre Extinguisher <br />Extra <br />Water <br />Exfra fee Baps & Food Containers must be <br />stored 6 inches otl of the ground! <br />5 Gal Hand wash <br />Wastewater Container