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Environmental Health Department <br />I* J h. <br />10. <br />11. <br />OR <br />12. <br />[x] Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />H One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />[x] Paper towels and pump-style soap container. <br />13. <br />**lmportant*‘ <br />ownerCompleted by: 14. <br />Title <br />Health Permit <br />Papef Hand Towels <br />BleachPropane Stove <br />1 <br />Prop ana Tank <br />Fire Extinguisher <br />Ice Cooler <br />TEMP EVENT APP <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />H Three compartment sink. <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 />Extra <br />Water <br />5 Gal Hand wash <br />Wastewater Container <br />5-20 Gal. <br />Hand wash Water <br />Garbage <br />Can <br />Sanitizer bucket- <br />bteech S water for <br />storing wiping cloths <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />Names of responsible persons to be present in booth during all hours of operation: <br />MJ Bermudez, Gefe Roaquin <br />Sterno w/Chaffing <br />Dish <br />SANJOAQUIN <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 /> Ice chests S Refrigerator <br />H Refrigerated truck Ice bath and tubs <br /> Other (specify) ___________________________ <br />I <br />Soap and Water <br />4/13/2025 <br />Date <br />5 <br />Rinse Water <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 />' Signature <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 0 of 11 TEMP EVENT <br />07/01/2024 <br />Soap dispenser \ <br />Extra /co Bags & Food Containers must Pel <br />stored 6 Inches off of the groundl I <br />Cutting Board