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Propane Tank <br />! Health Permit ! <br />Cutting Board <br />Extra <br />Water <br />5 Gal Hand wash <br />Wastewater Conta.ner <br />Paper Hand Towels <br />Sanitizer bucket- <br />bleach & water for <br />storing wiping cloths <br />Booth must be on <br />Concrete Asohalt <br />L. <br /> Plywood, or a Tarp j <br />al........... I -ire txtinguisner I <br />Ice Cooler Ja <br />fcc Scgc Fccd Ccntaincrc muct <br />stored 6 inches off of the ground! <br />SANAOAQUIN <br />f-)Li Nr-v <br />Environmental Health Department <br />in. ! nrn prnvirling the fnii^wing nn!ri ternpernti ire r•nntrn! fir the r'^!r4 h^frling rYf p.r,t_PrItinHy ha7arrIrmc frinric hple-mA, <br />45°F(if food is used the following day, maintain below 41°F temperature): <br />L21ce chests El Refrigerator <br />El Refrigerated truck fl Ice bath and tubs <br />7 Other (specify) <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />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 />El Detergent, bleach, and wiping cloths (cleaning towels). <br />tn cinrg, \tylping rfrIthcrihie2.ch crili firm <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 />11 One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />-1E1 f<per towels and pump-style soap container. <br />1,4 Names of responsible p rsons t47 1=ent in booth during all hours of operation: <br />lit -t-- <br />**Important** 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 />Completed by: Oto <br />21! eve <br />Title Date Signature <br />11-50-z5 <br />5-20 Gal <br />Hand wash Water <br />Sterno w/Chatting <br />Dish <br />Soap dispenser <br />Bleach- <br />\F:D1 r=41 I ri UU LxJU <br />L rGa-baange <br />I <br />Soap and Water <br /> <br />Rinse Water <br /> <br />Bleach and Water <br /> <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sjgov.org/ehd <br />EHD 16-02 Page 8of11 TEMP EVENT APP <br />06/29/2023