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Environmental Health Department <br />10. <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 />0 One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Paper towels and pump-style soap container. <br />13. <br />Completed by: 14. <br />Titlere <br />■ <br />Paper Hand Towels <br />Soap dispenser <br />Culling Board <br />BleachPropane Stove <br />L <br />Bleach and WaterRinse Waler <br />Fire Extinguisher <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />Sterna w/Chaffing <br />Dish <br />Extra <br />Water <br />Garbage <br />Can <br />Sanitizer bucket­ <br />bleach 8. water far <br />stonng wiping daths <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />S-20 Gai. <br />Hand wash Water <br />5 Gal Hand wash <br />Wastewater Container <br />SAN JOAQUIN <br />C O U N Y <br />Date <br />_z <br />Soap and Water <br />Propane Tank <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. S <br />_________ <br />Sign^oin <br />| Health Permit <br />** Im porta nt** <br />lap providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />’Tjfl Three compartment sink. <br />3 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 />[Z Detergent, bleach, and wiping cloths (cleaning towels). <br />H Tub to store wiping cloths in bleach solution. <br />I am 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 />® Ice chests Refrigerator <br /> Refrigerated truck Ice bath and tubs <br /> Other (specify)____________________________________ <br />Ice Cooler I i j <br />______V <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420] F 209 464-0138 | www.sjgov.org/ehd <br />EHD 16-02 Page 8 of 11 TEMP EVENT APP <br />07/01/2024 <br />Names of responsible persons to be present in booth during all hours of operation: <br />______C- _____________ <br />Extra /ce Bags & Food Containofs must bo I <br />stored 6 indies off of ttie gmund! f