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Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br />13.Nai p^^n^ir^booth jjurin^l <br />HAW tfC <br />Title Zl Date <br />14.Completed by: <br />Si|Title <br />Health Permit <br />l Paper Hand Towels <br />Soap dispenser <br />BleachPropane Siova <br />Propane Tank <br />Bleach and Waler <br />Fire Extinguisher <br />> <br />£HD 10.02 <br />07/01/2024 <br />Garbage <br />Can <br />Booth must be on <br />Concrete. Asphalt. <br />Plywood, or a Tarp. <br />Stemo w/Chaffing <br />Dish <br />S Gal Hand wash <br />Wastowaler Container <br />5-20 Gal. <br />Hand wash Waler <br />Sanitizer bucket­ <br />bleach & water for <br />Storing wiping cloths <br />Extra <br />Water <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />/^fwater supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />Zf One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />J^Paper towels and pump-style soap container. <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> 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 />O-Detergent, bleach, and wiping cloths (cleaning towels). <br /><0 Tub to store wiping cloths in bleach solution. <br />SAN JOAQUIN <br />------COUNTY------ <br />Greatness grows here. <br />I am providing the following cold temperature control for tine 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 Refrigerator <br /> Refrigerated truck Ice bath and tubs <br /> Other (specify) <br />iqaes of responsible persons to be present in booth during all hours of operation:V-yzKri Wuy Mow-din ___________ <br />**lmportant** 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 />Ice Cooler 1 uhbmhhhhhbhmhbi <br />jjr Extra tea Bags & Food Contalnen must bo 1 <br />. ... ........ ■ -........ stored 6 InchoB oft of the ground! ■ <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420) F 209 464-0138 | www.sjgov.ora/ehd <br />M Page 8 of 11 TEMP EVENT APP <br />Soap and Water Rinte Water <br />talure <br />Cutting Board