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Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br />0Water 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 coOection of rinse/wastewater. <br />0 Paper towels and pumo-stvie soap container. <br />13. <br />14.Completed by: <br />ignature <br />Health Permit <br />pjpet Hand Tomis <br />Scasdisoertset <br />Cuttk-rfl BoanJ <br />Ftopane SJO’* <br />I <br />SJcactisndWaer <br />Fire ExSngussfx* <br />(ce Cooler <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <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 />this event, <br />SWflW <*Ch»Sino <br />Oish <br />SGaiMsHivissh <br />C«djfcK.i <br />Garbage <br />Can <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 />B'ice chests □Refrigerator <br /> Refrigerated truck ice bath and tubs <br />□'Other (specify) TrloJ <br />O 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 />O Detergent, bleach, and wiping cloths (cleaning towels). <br /> Tub to store wiping cloths in bleach solution. <br />Am Bags t Pood Coraaincrs mat bo <br />Sored 6 AkMs oi 09 vovntf! <br />Booth must be on <br />Concrete. Asphalt, <br />Plywood, or a Taro. <br />Ssn^za bvckBt- <br />Mcsdi & wew fat <br />Kain; wpng dofts <br />SAN JOAQUIN <br />------COUNTY----- <br />5-70 GM. <br />rtarrf Water <br />( Eflra \ <br />PrTOKcTanfc“^3 <br />Names of responsible persons to be present in booth during all hours of operation: <br /> <br />**lmportant** <br />2-^ <br />DateTide <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />ETThree compartment sink. <br />1868 E. Hazeiton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />EHD16-02 Pogefiofu TEW EVENT APP <br />08/29/2023 <br />T <br />SoepsndV/efar