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r <br />Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br />my <br /> Paper towels and pump-style soap container. <br />13. <br />"Important** <br />14.Completed <br />Health Permit <br />Papw Hand Tow«<s <br />Cutting Board <br />Propane S’.ove <br />J a <br />Scap and Water Bleach and Water <br />Fire Extinguisher <br />Ice Cooler <br /> I <br />Slerno w/Cnafling <br />Dish <br />5 Gal Hand wash <br />Wastewater Container <br />Garbage <br />Can <br />Booth must be on <br />Concrete, Asphalt. <br />Plywood, or a Tarp. <br />Extra <br />Water <br />5-20 Gat. <br />Hand wash Water <br />Sanitrer buckel- <br />bieacn 4 water for <br />stcnng doths <br />Title <br />SAN JOAQUIN <br />------COUNTY------- <br />I Propane Tank <br />Narpes of responsible persons <br />XQ^^compart “PnlitemS b°Oth C,eaning °f f°Od preparation u,ensil <br />7 <br />Rinse Water <br /> I Soap dispenser <br />SSiSbles’pSnXXXfcnZll.T ",r '“''9 8"d On’ <br />L_ Detergent, bleach, and wiping cloths (cleaning towels). <br />LI Tub to store wiping cloths in bleach solution. <br />I am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br />AST (if food is used the following day, maintain below 41 °F temperature): <br />LI Ice chests LI Refrigerator <br />\0)Refrigerated truck Ice bath and tubs <br /> Other (specify) <br />I Bleacr <br />be present in booth during all hours of operation: <br />------- <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 />/Pert\rn original to festival coordinator three weeks prior to <br /> <br />Date <br />F-jtira fee Bags & Food Ccntamara must ba I i <br />--------------- at'jra<l 6 inchas eff of tha groundl ( <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 1 F 209 464-0138 I www.sjgov.org/ehd <br />06/29/2023 Pafi« 0 0(11 TEMP EVENT APR <br />•plater supply dispenser with warm water at a minimum of 100T (i.e. 5-20 gallon container with spigot). <br />Q One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />lam providing the following for adequate hand washing facilities, but separate from utensil wash within <br />DOO ill.