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Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br />13. <br />“Important** <br />14.I11-1^Signature Dater ibH <br />Health Permit <br />Paper Hana Towels <br />Soap dispenser <br />I <br />Cultirw; Board <br />Props-. Stove *.v Bleach <br /> u <br />Soap and Water Rinse Water <br />a1 <br />Ice Cooler <br />Completed by: <br />5 Gal Hand wash <br />Wastewater Conlarer <br />Garbage <br />Can <br />Sanitizer pucxet- <br />bleach & water for <br />storing wiping cloths <br />Eitra iarAegu A Food Containers must be <br />stored 6 jjcbos off of the ground' <br />Title <br />Booth must be on <br />Concrete. Asphalt <br />Plywood, or a Tarp. <br />&-20 Gal. <br />Hand wash Water <br />J3, Water supply dispenser with warm water at a minimum of 100aF (i.e. 5-20 gallon container with spigot). <br /> One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />FJ Paper towels and pump-style soap container. <br />/ Extra <br />Water <br />t » f -. <br />CTI f 'r° E’<!l^QU'she, <br />Sumo wiChatfng <br />j-l. ■ Dlsh <br /> <br />®XeVc^partX7srn3k.i,emS Wi,hin my b0°,h f°rlhe Sani‘ary C,eanln9 °,food <br />EH®toz Hazelton AvenLle 1 Stockton. California 95205 | T 209 468-3420, F 209 464-0138 | www.sjgov.org/ehd <br />06/19Z19 ! . ’ • Page B of 11 TEMP EVENT APP <br />2Z^on^bleX3S^bleX“n of wX™ for 3 b'eaCh <br />Q Detergent, bleach, and wiping cloths (cleaning towels). <br />I—I Tub to store wiping cloths in bleach solution. <br />^providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />Names of responsible persons to be present in booth during all hours of operation: <br />/lU______________________ <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 />praparation and operation. Return original to festival coordinator three weeks prior to <br />trws event, c--------- <br />SAN JOAQUIN <br />COUNTY — <br />,v. ‘l-feol nt-s! >W5 r>er e. <br />' WWRBHKSS — <br /> ice chests • Refrigerator <br /> Refrigerated truck |ce bath and tubs <br /> Other (specify)-