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Health Permit <br />Sterna w Chaffing <br />Dish <br />Gunnel Board <br />Propane Store <br />5-20 Gal. <br />Hand wash VValer <br />Soap dispenser <br />Garbage <br />Can <br />r <br />ice Cooler <br />Extra Ice Bags & Food Contaners Inset be <br />stored 6 inches off of the ground) <br />Paper Hand Towels <br />Sandizer bucket- <br />bleach & water tor <br />storing wping cloths <br />5 Gal Hand wash <br />Wastewater Container <br />Booth must be on <br />Concrete. Asphalt. <br />Plywood, or a Tarp. <br />DocuSign Envelope ID: A6E74685-DEDE-4900-90F6-8D6DC4F9DF9A <br />R EC-008 <br /> SANJOAQU I N 41.'1047 COUNTY <br />Environmental Health Department <br />-f-atness grows here <br /> <br />10. I am providing 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 />0 Ice chests Refrigerator <br />Refrigerated truck 0 Ice bath and tubs <br />Other (specify) <br /> <br />11. I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />EA Three compartment sink. <br />OR <br />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 />12. <br /> <br /> <br />0 Detergent, bleach, and wiping cloths (cleaning towels). 0 Tub to store wiping cloths in bleach solution. <br />I am providing the following for adequate hand washing <br />booth: <br />Water supply dispenser with warm water at a minimum <br />One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Paper towels and pump-style soap container. <br />facilities, but separate from utensil wash within my <br />of 100°F (i.e. 5-20 gallon container with spigot). <br />all hours of operation: Names of responsible persons to be present in booth during <br />Aaryn and Latisha Jones <br />—Important** All food vendor <br />preparation for <br />preparation and <br />this event. <br />booths are subject to inspection. Please make a copy of this application in <br />this event. A copy of this checklist must be in the booth at all hours of <br />operation. Return original to festival coordinator three weeks prior to <br />eSIgned Seamlesarkamocm <br />04 - 11 - 2024 <br />Completed by: OPP <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 www.sjgov.org/ehd <br />EHD 16-02 Page 8 of 11 TEMP EVENT APP <br />06"1W19 <br />443(8.141rfc12.1,1.0 <br />OlgilatUie Title Date