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10. <br />12. <br />13.Names of responsible persons to be present in booth during all hours of operation: <br /> <br />"Important*4 <br />14.Completed by: <br />Health Permit <br />Pb(ku H.-ndTCTt«is <br />CctUnc Board IPropano Slew <br />Frccsnt Tank <br />Btaodiand’Attor <br />Fira ExisnodshCf <br />ice Cooter <br />Ex!,'8 lc« BiQS & Fxx! Ccnfawe/s must b9 <br />stemd S inzhos off of the ground* <br />vrChsfi ing <br />Extra <br />Wafer <br />6-20 Got <br />Hend wash Water <br />5 Gal Hand wash <br />Waataweter Ccrtohar <br />Saritear bucMV <br />bfaach & wttsr for <br />•taring wiping do&a <br />ErwironmenUI Health Department <br />Title <br />SAN JOAOUIN <br />COUNTY <br />A Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />A,s 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 festive! coordinator three weeks prior to <br />this event — <br />Signature Title Date <br />Garbage <br />Can <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 /> Paper towels and pump-style soap container. <br />'StrfSnS toht?8 (baS'rtr!’8JnCheS l?inim1urn)- 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 />-§gLTub to store wiping cloths in bleach solution. <br />1°® chests Q Refrigerator <br /> Refrigerated truck Q ice bath and tubs <br /> Other (specify)_ <br />1868 E. Hazelton Avenue J Stockton, California 95205 | 7 209 468-3420 | F 209 464-0138 | www.sjqov oro/ehd <br />Pasoaor,-. TEMPEVENTAPP <br />11‘ □Thre0^Spa^XnV6518 W*hin h00* the Sanrta,y Cteaning °f utensil <br />OR <br />lam providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />DOuul.