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Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br /> Water supply dispenser with warm water at a minimum of lOOT (i.e. 5-20 gallon container with spigot). <br />One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Q Paper towels and pump-style soap container. <br />Names of responsible persons to be present in booth during all hours of operation:13. <br />“Important** <br />Completed by: 14. <br />Title Date <br />Papsr Hand Tcrovts <br />Soap d'sp»n«er <br />Cutting Board <br />El**acnPropono Sirxnt <br />i <br />Propano Tank <br />Ice Cooler <br />TEMP EVENT APP <br />Health Permit <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />EjtW /€• Saga 4 Food Containers mitt be <br />slorod b mcnes oH at the ground! <br />Stamo wiChaftru] <br />D.sh <br />5 Gal Hand wa»n <br />Wastewater Container <br />Garbage <br />Can <br />Booth must bo on <br />Concrete. Asphalt. <br />Plywood, or a Tarp. <br />SAN JOAQUIN <br />-----COUNTY------ <br />5-?0 Oat. <br />Hand wash Water <br />/OS <br />j Water <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> Three compartment sink. <br />‘TRj'hree 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 />_z <br />Rinw Waler <br />J <br />Soap and Water <br />1868 E. Hazelton Avenue I Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />EHO 16-02 Page 8 of 11 TEMP EVENT •! <br />08/19/19 <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 /> Refrigerated truck Ice bath and tubs <br /> Other (specify) <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 />Owner 08/19/2026 <br />Signature <br />| Fka Extinguisher <br />tl Ssivtrt' buckol- <br />blesch & water for <br />stonng wip.-ig clolhs