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Environmental Health Department i <br />11. <br />OR <br />I <br />12. <br />/^JWater supply dispenser with warm water at a minimum of 100’F (l.e. 6-20 gallon container with eplgot). <br /> One separate tub (bucket or basin) for the collection of rtnse/wastewater. <br />0 Paper towels and pump-stvle soap container. <br />•♦Important** <br />14. Completed by; i <br />Title <br />Health Permit <br />P^t Tw»» <br />6O4P (SlfXKlMt <br />CWIIdQ BMM <br />Prop»n» etovs <br />Match wd WatafSoapaAdWMw <br />Fl* Extinoulet'.M <br />TEMP EVENT APPPiQfl 8 of 11 <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <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 clothe In bleach solution. <br />BUmOvrfChaftnfl <br />DWi <br />oaalHandwath <br />WaiUw« Mt CofilaVw <br /> Booth muBl be on <br />Concrete, Aephoti, <br />Plywood, or a Tarp- <br />I <br />i <br />I <br />I <br />SMWMrbucUV kx ilorino wfpho ckXh» <br />Oarbaoo <br />Can <br />I MuKh <br />WftMWlkM <br />/ \ <br />I WMH I <br />ProptM Tt* «— ------------ <br />pee Cooler g <br />preparation and operation. Return original to feitlval coordinator three <br />thls.event, <br />__________ <br />Signature <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> Three compartment sink. <br />5-20 OW. <br />H«idwrfiW.u. <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 />-..............................................hrw week* prior to <br />z/2Z./g6 <br />Date <br />bi i Food C^>nt»hni trutlbi M <br />4ofvdfllnch«i oH ot lh» fjmndl ■ <br />1868 E. Hazelton Avenue | Stockton, California 96206 | T 209 468-3420) F 209 464-0138 | www.sjgov.org/ehd <br />EH01^02 P«0e8of11 TEMP EVENT Al <br />07701/2025 <br />13. Names of responsible persona to be present In booth during all hours of operation: <br /><24/2?rg/gL. <br />SANJOAOUIN <br />—county— <br />Grr?otnes$ grows herif. <br />10. lam 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 tuba <br />ELother (specify)