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marketer 1682126850 krehatian-kitchen-ehd2.jpg 00x4,000 pixels 5/8/23, 3:16 PM <br />Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br />13. <br />•‘Important" <br />Completed by:14. <br />Signature <br />Health Permit <br />Paper Hand Twroh <br />Saaj: atMenwri <br />JPropane Stove <br />Soap ano Waw <br />Fite Exltngutsber <br />TEMP EVENT APE <br />https://eventlocker.s3-accelerate.amazonaws.com/marketer 1682126850 krehatian-kitchen-ehd2.jpg Page 1 of 1 <br />f <br />2 in 1 Cop,/ Op’T°ns <br />scAn* <br />5 Gai Hand *ash <br />WastewiWer Ctmanet <br />Booth must be on <br />Concrete. Asphalt, <br />Plywood, or a Tarp. <br />Stomo wtChaffmg <br />Dish <br />Extra <br />Wate» <br />Sanituer bucket <br />btoacii & water tot <br />slonng wiping cloth* <br />Exira tee Bags & Food Conaners mu£ be sxxBd 6 reftes off or the gountf <br />1868 E Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | wv/vr sjgov org/ehd <br />EHD 16-02 PageBofU TcuPE^Hr*! <br />06'14'19 <br />A copy of this checklist must be in the booth at all hours of <br />Roturn original to festival coordinator three weeks prior to <br />> fiOiiLV' HllM25Tltio | <br />!^20 Gal <br />r- Hai ti wash Waler <br />____________ <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> Three compartment sink. <br />J/] Three deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br />Ablution (one tablespoon of bleach per gallon of water). <br />’^Detergent, bleach, and wiping cloths (cleaning towels). <br />TO 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 />^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 />f/j Paper towels and pump-style soap container. <br />Names of responsible persons to be present in booth during all hours of operation: <br />TtMyyK. ____________ ________ _______ <br />All food vendor booths are subject to inspection Please make a copy of this application in <br />preparation for this event <br />preparation and operation <br />this evpntTyg/ , „ <br />I Propane Tank <br />I B*** K <br />Rinse WUr Garbage” <br />Can <br />J | Bteacft and Water <br />Cuttnp Board <br />SANJOAOUIN <br />’ Eilk" 7 ------COUNTY------ <br />$!uor#'' Crentness growl 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 4TF temperature): <br />Ice chests Refrigerator <br /> Refrigerated truck jfe-lce bath and tubs <br /> Other (specify) _______________________—