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1 <br />11. <br />OR <br />12. <br />pr< <br />14. Completed by:\_L <br />Health Permit <br />PwaHMTmM <br />FropanaTMk <br />eiMcr. im w»m>Pnse WaiM <br />Ice Cooler <br />P»S«8of ” <br />SwmartXK**- <br />MKftlMMfta <br />aKnxl«a(M’ecM»» <br />6M»WX>MffAa <br />CM* <br />• QOkUndWMn <br />WaMwaM'Contara* <br />Gartwoe <br />Can <br />WO Gai <br />HwriwMhWM/ <br />'ehd <br />■VENT APP <br />13. <br />Booth must baon <br />Concftft. Asphaft. <br />Ptywood. oca Tarp. <br />| C^tngaoX <br />PMpMOOM <br />f <br />iWPl tX <br />Signature <br />SUpOwpanMf I ----------- <br />———j <br />X-'': <br />■i <br />i \ <br />io. <br />i <br />■».. Sffi ■«■ IMHIIBB-'JL ? -i ■■p ■■ <br />Environmental Health Department <br />O-MseXX------------------—---------------------—------------ <br />—All food vendor booths are subject to iRspectibh. Please make a “PV 5 <br />iration for this event. A copy of this checklist must be in the booth at all houra of <br />rat^Urttn>peratio?, Return original to festival coordinator three weeks prior to <br />^b&££_ <br />Title <br />_______V SXtt!S!£^l <br />1B6SE. Hazelton Avenue I Stockton, California 95206 | T 209 468-34201 F 209 464-0138 | www sjgov^ <br />EHD 1M» P*0«8olH <br />07/01/2024 <br />SAN JOAQUIN <br />& <) ------COUNTY------ <br />i-. jcs^v* Greotn.'M qrows '’C'f <br />' is'used the following day. <br /> ice cheats Ef Refrigerator <br />[^Refrigerated truck 1“balh and hjtis <br /> Other (specify)----------------- -------------------- --------- ------ <br />^providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />0Threecompartment sink. <br /> Three deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bteach <br />solution (one tablespoon of bleach per gallon of waler). <br /> Detergent, bleach, and wiping ctoths (cleaning towels). <br /> Tub to store wiping cloths in bleach solution. <br />I am providing the following for adequate hand washing facilities, but separate ffom utensil wash within my <br />Xfor supply dispenser with warm water at a minimum of 10OT (i.e. 5-20 gaiion container edth spigot). <br /> One separate tub (bucket or basin) for the collection of rinse/wastewater. <br /> Paper towels and pump-style soap container. <br />Names of responsible pedons to be present in booth during all hours of operation: <br />-nmportanT*