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Environmental! Heaith Department <br />10. <br />11. <br />OR <br />12. <br />13. <br />14. Completed by: <br />Health Permit <br />Paper Hand Towels <br />Soep dlspensar <br />Cutting Board 3 iBleachPropane Siove <br />0ftft <br />Propane Tank <br />Rinse Water <br />i Ice Cooler <br />TEMP EVENT APP <br />liiigans <br />Stemo w/Chaffing <br />Dish <br />5 Gai Hand wash <br />Wastewater Container <br />8-20 Gal. <br />Hand wash Water <br />Garbage <br />Can <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />j^Water supply dispenser with warm water at a minimum of WOT (i.e. 5-20 gallon container with spigot). <br />QjOne separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Q Paper towels and pump-style soap container. <br />Extra tea Baoa A Food Containers must be <br />stored 8 tocftes offor tfte proundr <br />Extra <br />Water <br />Sanitizer buckat- <br />Mesch 8 water for <br />storing wiping ctothe <br />SAN JOAQUIN <br />COUK-''' <br />Signature <br />1068 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3-120 | F 209 464-0138 | www.sjgov.org/ehd <br />EHD 16-02 Page 8 of 11 ■ —A: <br />07/01/2024 <br />□^P|^^m^^nktemS W"hin my b°Oth lhe Sanitary Cleanin9 Of '°Od PreParation utensil <br />chests Q Refrigerator <br /> Refrigerated truck ice bath and tubs <br /> Other (specify) <br />_L <br />Soap and Water <br />fOr SOaPy Water' One for rlnsln9 and °ne for a b,9ach Detergent, bleach, and wiping cloths (cleaning towels). <br /> Tub to store wiping cloths in bleach solution. <br />booth ^le Stowing for adequate hand washing facilities, but separate from utensil wash within my <br />Names of responsible persons to be present in booth during all hours of operation: <br />1^ A n \/C- ) a <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 /> <br />Title Date