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10. <br />11. <br />OR <br />12. <br />Q^aper towels and pump-style soap container. <br />13. <br />••Important** <br />Completed by: 14. <br />Health Permit <br />Paper Hand Towels <br />Soap dispenser <br />BiMChPropane 9to«« <br />X <br />Propane Tar* <br />Bleach and Water <br />Ere ExtMXXMher <br />Ice Cooler <br />Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot) <br />Q/One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Stemo a^ChaMng <br />Osh <br />5 20 Gal <br />Hand wash Water <br />Garbage <br />Can <br />Sanrtizei bucxet <br />bleach & waler lor <br />storing wiping cloths <br /> Booth must be on <br />Concrete. Asphalt. <br />Plywood, or a Tarp. <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />5 Gal Hand wash <br />Wastewater Container <br />SAN JOAQUIN <br />COUN I Y <br />Title <br />J <br />Soap and Water <br />r <br />RmeVWter <br />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 and operation. Return original to festival coordinator three weeks prior to <br />this event <br />________OuVxpJ2—_________CAJ <br />Signature______Title____________Date <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> Three compartment sink. <br />Q^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 />□TDetergent, bleach, and wiping cloths (cleaning towels). <br />S'! ub to store wiping cloths in bleach solution. <br />Eitra toe Begs X Food Containun must ba I <br />stonO 6 Mas oH of tha gmund1 I <br />Environmental Health Department <br />1868 E. Hazelton Avenue | Stockton. California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />EHD IB-02 Page 8 0(11 TEMP EVENT APP <br />07/01/2025 <br />Names of responsible persons to be present in booth during all hours of operation: <br />__________