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Environmental Health Department <br />w. <br />11. <br />OR <br />one for a bleach <br />12. <br />13. <br />14.Completed by: <br />Health Permit <br />PHarxJ Towels <br />Soap dispense* <br />Gulfing Board <br />Propane Sto»e Bleach <br />11 <br />Rinse Water Blear Ji rvxl Waler <br />F«e Erdinauraher <br />Ice Cooler <br />1 <br />Eitra Ice I, food ConlainHrt must be <br />sforerl <5 inches I'd ol tr» ground1 <br />preparation and operation. <br />this event. <br />Slerno w/Chaffmg <br />Dish <br />Garbage <br />Can <br />Booth must be on <br />Concrete. Asphalt <br />Plywood, or a Tarp <br />5 Gal Hand wash <br />Wastewater Conbnnnr <br />5 20 Gal <br />Hand wash Water <br />SarMizer buc*el <br />blaacb » water for <br />stnrsig wfwg ' Whs <br />Propane lank <br />Soap and WalM <br />IS within my booth for the sanitary cleaning of food preparation utensil <br />SANJOAOUIN <br />COUNTY------ <br />Greotness grows here. <br />providing the following cold temperature <br />□ Water supply dispenser with warm water at a minimum of 100T (i.e. 5-20 gallon container with spigot) <br /> One separate tub (bucket or basin) for the collection of rinse/wastewater. <br /> Paper towels and pump-style soap container. <br />lam providing the following item: <br /> Three compartment sink. <br />Su“e^n^ ,Or S°aW rinsing and <br />LJ Detergent, bleach, and wiping cloths (cleaning towels). <br />l_l Tub to store wiping cloths in bleach solution. <br />Names of responsible persons to be present in booth during all hours of operation <br /> -------------------- LYOUM. KlyyvOWvu) VGd <br /> <br />“Important** All food vendor booths are subject to inspection.preparation for this event. A copy of this chec^Z™^ XVK of <br />Return original to festival coordinator three weeks prior to <br />--------------kWYxjf______O /zu llv? 0> <br />Title Bate <br />/P <br />>1 ■ <br />otS “•—— <br /> Refrigerated truck Ice bath and tubs <br /> Other (specify) <br />7 Signature <br />1868 E Hazelton Avenue | Stockton, California 95205 | T 209 468-3420) F 209 464-0138 | www sjgov org/ehd <br />EHO 16-02 Page 8 of 11 TEMP FVENT APP <br />07/01/2025 <br />I am providing the foltowing for adequate hand washing facilities, but separate from utensil wash within my <br />Fit/a <br />Water