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i <br />Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br />within my <br />13.Names o^msponsible persons to preset in booth during all hours of operation <br /> <br />“Important’* <br />14.Completed by: <br />Health Permit ' <br />Paper Hand Towels <br />Propane Stovo <br />Propano Tank <br />□loach and Water <br />Fire Extinguisher <br />Ice Cooler <br />o, Hazelton Avenue 1 Stockton. California 95205 | T 209 468-3420 | F 209 464-0138 | www.sigov.orq/ehd <br />07/01/2024 Pa9C ° 11 TEMP EVENT AlTEMP EVENT APP <br />Cxtra /co Bags & Food Containois must bo <br />stored 6 inches otf of the ground' <br />Sterno w/Chaffing <br />□ish <br />Extra <br />Water <br />!> Gal Hand wash <br />Wastewater Container <br />Garbage <br />Can <br />5-20 Gal. <br />Hand wash Waler <br />Signati <br />SAN JOAQUIN <br />COUNTY <br />Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />£ione separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Paper towels and pump-style soap container. <br />Rinse Water <br />J <br />Soap and Water <br />• Return original to festival coordinator three weeks prior to <br />(Ok)her <br />Title Date* <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 and operatic^. Return original to festival coordinator three weeks nrinr tn <br />this\ayent. <br />lam providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />1_| Three compartment sink <br />1 axTofr?yid'ng the followiri9 cold temperature control for the cold holding of potentially hazardous foods below <br />45 F (if food is used the following day, maintain below 410F temperature): <br />y^Llce chests Refrigerator <br /> Refrigerated truck ice bath and tubs <br /> Other (specify)____________ <br />| Soap disponsor <br />□loach <br />wo <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash <br />booth: <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 />0'Detergent, bleach, and wiping cloths (cleaning towels). <br />£5 Tub to store wiping cloths in bleach solution. <br />Sanltiior buckot- <br />blcach & walor tor <br />storing wiping cloitis <br />Booth must be on <br />Concrete, Asphalt, i <br />Plywood, or a Tarp. j <br />Cutting Board