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Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br />utensil wash within my <br />Paper towels and pump-style soap container. <br />13. <br />14.Completed by: <br />Health Permit <br />Paper Hand Towels <br />Soap dispenser <br />Cutting Board <br />Propane Stove Bleach <br />Propane Tank <br />Fire Extinguisher <br />Page 8 of 11 <br />Soap and Water <br />EHD 16-02 <br />06/19/19 <br />5 Gal Hand wash <br />Wastewater Container <br />Garbage <br />Can <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping doths <br /> Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />Stemo w/Chaffing <br />Dish <br />5-20 Gal <br />Hand wash Water <br />Extra <br />Water <br />Ice Cooler | <br />Extra Ice Bags & Food Containers must be I <br />stored 6 Inches off of the ground! i <br />Bleach and Water <br />**lmportant** <br />Names of responsible persons to be present in booth during all hours of operation: <br />Rinse Waler <br />booTh Pr°Vldin9 1116 fol,owin9 for adequate hand washing facilities, but separate from <br />0Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />[El One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />Page 8 of 11 TEMP EVENT APP <br />^ifreeXa" my b0°,h f°r the Sanit^ clea"in9 °f Potion utensil <br />XnXtesX3 orbie^cC^nXa^r f°r and °"e for a bleach <br />LypDetergent, bleach, and wiping cloths (cleaning towels) <br />LJ Tub to store wiping cloths in bleach solution. <br />SAN JOAOIJIN <br />------COUNTY------ <br />'■ tyr-otf1' Greatness grows here. <br />(Mice chests q Refrigerator <br /> Refrigerated truck ice bath and tubs <br /> Other (specify) <br />QEoJ Ltrf. S/'f'llZCgy'______________ <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 />and °Pera^on- Return original to festival coordinator three weeks prior to <br />__________________________________ <br />'Signature Title 'Date'