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Environmental Health Department <br />11. <br />OR <br />12. <br />I3 Paper towels and pump-style soap container. <br />13. <br />Important <br />14. <br />Signature <br />1| Health Permit |* <br />Paper Hand Towels <br />Soap dispenser <br />Cutting Board <br />Bleach <br />Soap and Water Rinse Water Bleach and Water <br />Fire Extinguisher <br /> Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br /> One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Extra <br />Water <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />Stemo w/Chaffing <br />Dish <br />5 Gal Hand wash <br />Wastewater Container <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping doths <br />5-20 Gal. <br />Hand wasri vvaier <br />...N -------------------------------- <br />______________ZI <br />Ice Cooler u <br />_________> <br />SAN JOAQUIN <br />-----COUNT Y------ <br />Greatness grows here. <br />r’-.-X-k! <br />Propane Tank <br />------------------- -—I <br />/ <br />I am | <br />45°F (if food is used the following day, maintain betow 41 °F temperature): <br />KI Ice chests Q Refrigerator <br /> Refrigerated truck Ice bath and tubs <br /> Other (specify)_____________________ <br />8/29/2025 <br />Date <br />l_am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />l_j Three compartment sink. <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 />Completed by: Rowena Rono <br />Names of responsible persons to be present in booth during all hours of operation: <br />Rowena Rono / Joy Ramirez <br />Extra Ice Bags & Food Containers must be E <br />VW V w w> < <br />^BSfnazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 I www.sjgov orq/ehd <br />07/01/^24 Pa988Of11 TEMPEVENTAPP <br />^arr^providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />Garbage <br />Can <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 />lJ Detergent, bleach, and wiping cloths (cleaning towels). <br />K Tub to store wiping cloths in bleach solution. <br />Owner______ <br />Title <br />VI 1 <br />| Propane Stove | <br />I_______________I I <br />10.providing the following cold temperature control for the cold holding of potentially hazardous foods below