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Environmental Health Department <br />10. <br />wlrOf <br />OR <br />12. <br />£3~Water 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 />13. <br />Completed by: 14. <br />:ure <br />Health Permit <br />Paper Hand Towals <br />Soap dispenser <br />Cultina Boord a Bleach <br />Propane Stove <br />5 <br />propane Tar* <br />Bleach and Waler <br />J <br />Ice Cooler <br />storad 6 inches off of tho groundl <br />Sterno w/Chaffing <br />Dish <br />Garbage <br />Can <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 vrash Water <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping doths <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />MJ <br />*l <br />SAN JOAQUIN <br />C O U I-'. " v <br />Extra Ico Bags S Food Containers must be I <br />Waler <br />Title <br />I <br />Soap and Water Rinse Water <br />11. lam providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> Three compartment sink. <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 />Detergent, bleach, and wiping cloths (cleaning towels). <br />Tub to store wiping cloths in bleach solution. <br />1868 E. Hazelton Avenue j Stockton, California 95205^ T, <br />EHD 16-02 <br />07/01/2024 <br />••Important**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 andpperation. Return original to festival coordinator three weeks prior to <br />this event <br />Date <br />- 209 A68~3420 I F 209 464-0138 | www.sjgov.org/ehd <br />,7. TEMP EVENT APP <br />Page 8 of 11 <br />| Firo Extinouishsr <br />j^Paper towels and pump-style soap container. <br />Names of responsible person^ to be present in booth during all hours of operation: <br />fceYwen ____________ <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 />S' Other (specify) Vio cq'cA To