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7/24/23, 1:53 PM imageO.jpeg <br />n« <br />Environmental Health Department <br />— <br />10. <br />11. <br />OR <br />12. <br />5-20 gallon container with spigot). <br />13. <br />•* Important** <br />this event. <br />Completed by:14.Signature <br />Health Permit Paper Hand Towels <br />Propane Stove <br />Propane Tank <br />Rinse WaterSoap and Water <br />Fire Extinauisher <br />https://mail. google. com/mail/u/0/#search/FLAVOR+F/KtbxLrjNcfTMsLgKxQSPBgVfvpNJXvVIIB?projector=1 1/1 <br />Sterno w/Chaffing <br />Dish <br />Garbage <br />Can <br />Sanitizer bucket- <br />Dleacn i water for <br />itonng wiping cloths <br />Booth must be o <br />Concrete, Aspha <br />Plywood, or ala <br />5 Gal Hand wash <br />Wastewater Container <br />5-20 Gal <br />Hand wash Water <br />SAN JOAQUIN <br />COUNTY <br />Cutting Board | <br />Extra X <br />Water <br />IceCooier J <br />O>4 <br />Title <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 />□Jce chests zS Refrigerator <br />'Q'Refrigerated truck Ice bath and tubs <br /> Other (specify)__—-------------------------------------------------------- <br />1868 E. Hazelton Avenue | Stockton, California 9520^ 1^209 468 342 I <br />EHD 16-02 <br />Iwe4a/4fk: . . : <br />Extra Ice Bags 4 Food Containers must be <br />stored 6 inches off of the ground! <br />209 464-0138 | www sjgovo^ehdp <br />| | Paper towels and pump-style soap container. <br />Names of responsible persons to be present in bopth during all hours of operation. <br />--------------- - ---------------------- <br />lamproviding the following items within my booth for the sanitary cleaning of food preparation utensil <br />SCfhree compartment sink <br />-------------------------------- t L piease make a copy of this application in <br />this event A copy of this checklist must be in the booth at all hours of <br />htroeration. Return — --------------------------- <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 /> Tub to store wiping cloths in bleach solution. <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />^p^Water supply dispenser with warm water at a minimum of 100 F (i,e <br /> One separate tub (bucket or basin) for the collection of rinse/wastewater <br />All food vendor booths are subject to <br />preparation for <br />preparation ar* <br />originarto festival coordinator three weeks prior to <br /> <br />Dilte <br />Soap dispenser <br />Bleach