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Environmental Health Department <br />10 <br />11 <br />OR <br />12 <br />S 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 /> Paper towels and pump-style soap container <br />13. <br />‘•Important** <br />Completed by14. <br />Health Permit <br />F Hnnrt Tnw»K <br />Cutt'OQ Board <br />fropanfl Stove <br />Froour’e Tank <br />Soap and Wrier Rinse Water Bieacn and Water <br />Fire E>tirxjuisner <br />Names of responsible persons to be present in booth during all hours of operation. <br />Darva Artsyman <br />Garbage <br />Can <br />iantliier bocKel- <br />C eacn & water tor <br />storing wiping cioins <br />Booth must be on <br />Concrete, Asphalt. <br />Plywood, or a Tarp <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 />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth <br />Exva <br />Water <br />6 Gai Hand wash <br />Wastewater Container <br />Stemo w/Cnatfir>g <br />Dtst. <br />5-20 Gal <br />Hand wash Waler <br />SANJOAOUIN <br />-COUNTY------ <br />Representative <br />Title <br />iUWS <br />Greatness grows here. <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 />[X] Ice chests Refrigerator <br /> Refrigerated truck Ice bath and tubs <br /> Other (specify) <br />1868 E. Hazelton Avenue | Stockton. Californ a 95205 | T 209 468-3420) F 209 464-0138 | www.sjgov org/ehd <br />EHD 16 02 Page 8 of II TEMP EVENT APP <br />07/01/2025 <br />Enra roe Bags S Food Containers must » ■ <br />stom‘16 irjcfws off o' the grouna1 | ‘ <br />6-12-26 <br />Date <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />Three compartment sink <br />z-- <br />Ice Cooler • <br />All food vendor booths are subject to inspection. Please make a copy of this application in <br />preparation for this event. aA copy of this checklist must be in the booth at all hours of <br />preparation and operation //Return pjiginal to festival coordinator three weeks prior to <br />this event, J // <br />Soap dispense <br />Bleach