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Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br />13. <br />**lm portant** <br />Completed by: 14. <br />Paper Hand Twell <br />i <br />Propan* Stov* <br />Bl«adi and Waler <br />Are Extinguisher <br />I <br />Ice Cooler <br />i<T> <br />I <br />f <br />! <br />I <br />5 I.• <br />5 Gal Hand wash <br />Wastewater Container <br />Garbage <br />Can <br />I <br />Stemo w/Chaffing <br />Dish <br />5-20 Gal. <br />Hand wash Water <br />Sanitizer bucket- <br />bleach S. water tor <br />stonrig wiping doUis <br />Extra <br />Water <br />I I <br />Bleach <br />Propane Tank <br />Ejtn Ice Begs i Food Containers must be H <br />stored S inches off of the ground! ILS <br />Cutting Board <br /> Booth must be on <br />Concrete, Asphalt. Plywood, or a Tarp. <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot), <br />[^fone separate tub (bucket or basin) for the collection of rinse/wastewater. <br />^Paper towels and pump-style soap container. <br />Nar^es^f responsible persons to pe present in booth during all hours of operation: <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 /> <br />Signature I fj Title Date I <br />i <br />j <br />SAN JOAQUIN <br />------COUNTY------- <br />Greotness grows here. <br />I amjoroviding 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 />EJ Ice chests [^Refrigerator <br /> Refrigerated truck Ice bath and tubs <br /> Other (specify)_______________________________ <br />lam providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> Three compartment sink. <br />1S 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 />'WDetergent, bleach, and wiping cloths (cleaning towels). <br />'"Si Tub to store wiping cloths in bleach solution. <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420) F 209 464-0138 | www.sjgov.org/ehd <br />EHD 16-02 Page 8 of 11 TEMP EVENT APP <br />07/01/2025 <br />| So»p disp*nw | -------- <br />Soap and Water Rinia Water <br />Health Permit