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Environmental Health Department <br />11. <br />OR <br />12. <br />Water supply dispenser with warm water at a minimum of 10OT (i.e. 5-20 gallon container with spigot). <br />13. <br />5 ( <br />Completed by: 14. <br />DateTitleSignature <br />Health Permit <br />Paper Hand Towels <br />Soap dispenser <br />Cutting Board <br />BleachPropane Stove <br />Propane Tank <br />Bleach and Water <br />Fire ExtinguisherQ <br />Ice Cooler <br />TEMP EVENT APP <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 />KI Detergent, bleach, and wiping cloths (cleaning towels). <br /> Tub to store wiping cloths in bleach solution. <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> Three compartment sink. <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />Extra Ice Bags & Food Containers must be <br />stored 6 inches off of the ground! <br />Extra <br />Water <br />Garbage <br />Can <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping cloths <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />Sterno w/Chaffing <br />Dish <br />5 Gal Hand wash <br />Wastewater Container <br />5-20 Gal. <br />Hand wash Water <br />SAN JOAQUIN <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 Refrigerator <br />Kl Refrigerated truck {2 Ice bath and tubs <br /> Other (specify)__ ___________________________ ____ <br />Soap and Water Rinse Water <br />**lmportant** <br />One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />I^Paper towels and pump-style soap container. <br />btemes ofxesponsible persons to be present in booth dwAng all hours of oppr^ion: , I <br />•UjlAA \ vo \J (X c f C i.A11 rli __.fY-rr-t/rro <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 />10. <br />1868 E. Hazelton Avenue I Stockton, California 95205 | T 209 468-3420 [ F 209 464-0138 | www.sjgov.org/ehd <br />EHD 16-02 Page 8 of 11 TEMP EVENT A! <br />07/01/2025