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WCTl< <br />Environmental Health Department <br />10 <br />lanrf providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />Three compartment sink. <br />11 <br />OR <br />12. <br />13. <br />"Important <br />Reti <br />Completed by-.^^^^14. <br />Sig1 ce <br />Health Permit <br />Paper Hund lowntj <br />CulUnq Board <br />Propnno Stovo Bloacb <br />11 <br />BiMch and Wntor <br />Firo Ertlnqulshera <br />Ice Cooler <br />Pano 8 o( 11 <br />aoojhs are si <br />>rfs evept <br />operatioi <br />Garbage <br />Can <br />www.sjgov.org/ehd <br />TEMP EVENT APP <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp <br />Slamo w/Chnffing <br />& ah <br />Eidra <br />Watar <br />5 Gai Hand woah <br />Wnatowato' Container <br />5-20 Gal <br />Hand wash Wator <br />Sanitizer bucket- <br />b.'ojch 4 water lor <br />etonng wplng floThi <br />SAN JOAQUIN <br />COUNTV <br />Title <br />1 <br />Soap and Water <br />46T (if food is used the following da; <br />0 ICe chests [ <br />Refrigerated truck L <br />El Other (specify) <br />I am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br />I daZpiaintaln below 41 °F temperature) <br />[tWefngeralor <br />□ Ice bath and tubs <br />Soap dsponier <br />trim /co Sags & Food Contamon must Im I j <br />storod 6 mcf’os off of (ho gmmdl [ J <br />I am | <br />boopf <br />0 Water supply dispenser with warm water at a minimum of 10O’F (i e 5-20 gallon container with spigot). <br />I^pne separate tub (bucket or basin) for the collection of nnse/wastewater. <br />□ Paper towels and pump-style soap container <br />R'nso Wnt»r <br />Names of responsible persons to be present in booth during all hours of operation: <br /> <br />)ject to inspection. Please make a copy of this application in <br />copv/Of this checklist must be In the booth at all hours of <br />.tom original to festival coordinator three weeks prior to <br />5/^ / <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 />providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420] F 209 464-0138 | <br />EHD 16-02 Pago 8 of 11 <br />07/01/2024 <br />All food vendor <br />preparathp^for <br />prepaj^i^p^jffio