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Environmental Health DepartmentSAN>JOAQUIN <br />11. <br />OR <br />12. <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 />13. <br />Important** <br />14. <br />Health Permit <br />Paper Hand <br />Soap dispenMr <br />Cutting Board <br />BieacfiPropane Stove <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />3 Three compartment sink. <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 /> Detergent, bleach, and wiping cloths (cleaning towels). <br /> Tub to store wiping cloths in bleach solution. <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />Names of responsible persons to be present in booth during all hours of operation: <br />Ruben Caballero <br />Stemo w/Chaffing <br />Dish <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />5 Gal Hand wash <br />Wastewater Container <br />Garbage <br />Can <br />Sanitizer budtet- <br />bleach & water for <br />storing wiping dotha <br />R <br />\ <br />Bleach •nd Water <br />T <br />Soap and Water <br />Representative <br />Title <br />4-24-25 <br />Date <br />/ <br />Rinse Water <br />Propane Tank “--------------------------- <br />Ice Cooler J □■■■ <br />Extra Ice Bags & Food Containers must be H <br />stored 6 inches oft of the ground1 H <br />............................______________ <br />: _..i 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 />s Ice chests Refrigerator <br /> Refrigerated truck Ice bath and tubs <br /> Other (specify)-____ __ ____________________—----------------------- <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 anef operation. Return original to festival coordinator three weeks prior to <br />this event. // <br />Completed by: A7 — <br />Signature <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />EHD 18-02 Page 8 of 11 TEMP EVENT APP <br />07/01/2024 <br />Fire Extinguisher <br />/ffh SANJOAQUIN <br />) -----COUNTY----- <br />Greatness grows here. <br />10. I am | <br />5-20 Gai. <br />Hand wash Water