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Environmental Health Department <br />* <br />12. <br />13. <br />MW14.Completed by. <br />Signature <br />Health Permit <br />Paov Hard Iowan <br />I <br />41 <br />Ice Cooler J <br />PaQO B d H <br />£>tza Kx Bags 4 Food Containers must be <br />Mored 8 inches off ortho ground' <br />Garbage <br />Can <br />5-20 Gat <br />Hand wash Water <br />Saratzer Bucaet- <br />aea<h 4 •atw tor <br />sxcrr^ vpsrq dco» <br />SMi HJMMH <br />COkJNl v <br />Booth must be on <br />Concrete, Asphalt. <br />Plywood, or a Tarp <br />v____________ <br />StemowrOn <br />Di*h <br />I Prnoane I ank <br />Na^Ss *be rg inya"h0UfS of <br />All tood vendor booths <br />preparation <br />preparation land <br />this eventAx i <br />1868 E Hazelton Avenue | Stockton, California 95205 \ 1 20J 468-3420 \ <br />EHD 16-02 PaoeBolH <br />07/01/2024 <br />Bleatfund Water <br />Vaster supply dispenser swith warm water at a minimum of 1007 (i.e. 5-20 gallon container with spigot) <br />S'One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />IJ^aper towels and pump-style soap container. <br />I Bead <br />•’Important** <br />I Propene Stove <br />| Soap dHponw | --------- <br />are subject to inspection. Please make a copy of this application in <br />ITtl^is event. A copy of this checklist must be in the booth at all hours of <br />sration. Return original to festival coordinator three weeks prior to <br />MW <br />Title Date <br />I 5-20 Gal I <br />r- I Hand wash Water 1 <br />* vsawUMrt«* <br />^ChMh HReMgerato, <br />DicebethAMtubs <br />U Othet (specity) <br />O Three compartment sinkboo'h *0( the sanrtary cleaning of food preparation utensil <br />006 f°r S°aPy Water’ °ne f°r r'nS'n9 and °ne f°r 3 bleach <br />^providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />7Rinae Water I I <br />I E-lnA <br />I Water ILJ <br />f BGal Hand weih I-----------' <br />I Wa»lewo'« Container I I <br />209 464-0138 | www s19ovo^ehd)p <br />I CJttnj Board <br />Soap and Water <br />F«e Extinguihec |