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Environmental Health Department <br />10 <br />OR <br />12 <br /> Water supply dispenser with warm water at a minimum of 100*F (i.e. 5-20 gallon container with spigot). <br />13. <br />••Important** <br />14.Completed by; <br />Health Permit <br />Cvtovjeood <br />Pl W* j'eio <br />I <br />H-l-O^ocb am Wclor <br />f«« Curovuba <br />Ice Cooler <br />Siixno w-Ouftno <br />0&1 <br />ko < food Cofionon »• <br />e »xbe» oA o<cna <br />Wm>o»«w Cortoirot <br />Booth must be on <br />Concrete. Asphalt <br />Plywood, or a Tarp. <br /> One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Paper towels and pump-style soap container. <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />$-» C«i <br />Kond -Bih Wolor <br />Garbage <br />Can <br />Names of responsible persons to be present in booth during all hours of operation; <br />_____________ <br />SaixMC» t>uck«|. bUKh S wsior lor <br />tlorng w«ng ctotr>» <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 />•0 Detergent, bleach, and wiping clolhs (cleaning towels). <br /> Tub to store wiping cloths In bleach solution. <br />Title <br />I Piooono Took <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.. . n <br /> <br />Signature Date <br />SAN JOAQUIN <br />------COUNTY------- <br />u*"-' Greotm’ss groivs 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 /><0 Ice chests Refrigerator <br /> Refrigerated truck Ice bath and tubs <br /> Other (specify)_____________ <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> Three compartment sink <br />I S»oa oaoontor -------- <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />EMO 16-02 Pogo 8o(H TEMP EVENT APP <br />07/01/2025 <br />5cx> o-d Vio-o- Rnjo