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Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br />4^^/Vater supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />>pth durino all hours of operation <br />Rivera Calvo <br />13. <br />“Important1 <br />Completed by: 14. <br />Signature <br />Health Permit <br />Paper Hand Towels <br />Soap dispenser <br />BleachPropane Stove <br />D U 0III <br />Rinse Water Bleach and Water <br />-ire Extinguisher <br />Ice Cooler <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />@^hree compartment sink. <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 /> Ice chests ^Refrigerator <br /> Refrigerated truck Ice bath and tubs <br /> Other (specify) <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 /> One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />^^^per towels and pump-style soap container. <br />Slemo w/Chaffing <br />Dish <br />Extra <br />Water <br />5 Gal Hand wash <br />Wastewater Container <br />Garbage <br />Can <br />Sanitizer bucket­ <br />bleach & waler for <br />storing wiping cloths <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />SAN JOAQUIN <br />COUNTY <br />Owner <br />Title <br />6/2/2026 <br />Date <br />Propane T ank <br />Nam^ of re^ons^ble p^ons^t^be^pr^se^ ki^boj <br />5-20 Gal. <br />Hand wash Waler <br />r_L <br />Soap and Water <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />EHD 16-02 Page 8 of 11 TEMP EVENT APP <br />06/19/19 <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 />preparation('arWsoperation. Return original to festival coordinator three weeks prior to <br />this eventA <br />Extra Ice Bags & Food Containers must be I <br />stored 6 Irenes offol the ground1 <br />Cutting Board