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Environmental Health Department <br />10. <br />serve machine <br />11. <br />OR <br />for soapy water, one for rinsing and one for a bleach <br />12. <br />13. <br />‘‘Important** <br />14.Completed by: <br />Signature <br />Health Permit <br />Paper Hand Towels <br />Soap dispenser <br />Cutting Board 3Propane Stove Bleach <br />flPropane Tank <br />Rinse Water <br />Ice Cooler J <br />Sterno w/Chaffing <br />Dish <br />Extra <br />Water <br />Garbage <br />Can <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping cloths <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp <br />5 Gal Hand wash <br />Wastewater Container <br />5-20 Gal. <br />Hand wash Water <br />www.sjgov.org/ehd <br />TEMP EVENT APP <br />SAN JOAQUIN <br />-COUN~v <br />Bwater 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 />C? Paper towels and pump-style soap container. <br />8/16/2025 <br />Date <br />All food vendor booths are <br />preparation for this event, <br />preparation and operation. <br />this event. <br />^h^Xrtmenrs^."6"15 Cleanin9 °f f°°d ^nsil <br />in booth during all hours of operation: <br /> <br /> <br />Names of responsible persons to be present <br />Patricia Hansen <br />Q Three deep tubs (basins 6-8 inches minimum), one <br />solution (one tablespoon of bleach per gallon of water). <br /> Detergent, bleach, and wiping cloths (cleaning towels) <br />LJ Tub to store wiping cloths in bleach solution. <br />Bleach and Waler <br />J Ice chests Q Refrigerator <br /> Refrigerated truck |Ce bath and tubs <br />SOther (specify) chest freezer, refridgerated soft <br />I f i I r~~I 1^2 <br />/^\ |Fire Extinguisherm ----- <br />I am^praviding the following for adequate hand washing facilities, but separate from utensil wash within my <br />Extra Ice Bags & Food Containers must be 1 - <br />stored 6 inches off of the ground! | <br />EHD®-o2 Hazel,on A'/eniJe I stockton, California 95205 I T 209 468-3420 | F 209 464-0138 I <br />07/01/2024 Page 8 of 11 <br />subject to inspection. Please make a copy of this application in <br />A copy of this checklist must be in the booth at all hours of <br />Return original to festival coordinator three weeks prior to <br />______________Owner <br />Title