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Environme .al Health Department <br />control for the cold holding of potentially hazardous foods below <br />10. <br />freezer <br />11. <br />OR <br />12. <br />13. <br />Completed by.14. <br />Health Permit Paper Hand Towels <br />Soap dispenser <br />Cutting Board <br />Bleach <br />Propane Stove <br />JI\l <br />Propane Tank <br />Bleach and WaterSoap and Water <br />Fire Extinguisher <br />Ice Cooler <br />, California 95205 | T 209 468-3420 | F <br />Page 8 of 11 <br />LI <br />1868 E. Hazelton Avenue | Stockton <br />EHD 16-02 <br />06/29/2023 <br />5 Gal Hand wash <br />Wastewater Container <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping cloths <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />owner <br />Title <br />Garbage <br />Can <br />Extra Ice Bags & Food Containers must be <br />stored 6 inches off of the ground! <br />209 464-0138 I www.sjgov.org/ehd <br />TEMP EVENT APP <br />"Important** <br />s Water supply dispenser with warm water at a minimum ot 100T (i.e. 5-20 gallon container with spigot). <br />0 One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Q Paper towels and pump-style soap container. <br />Names of responsible persons to be present in booth during all hours of operation: <br />Muhammad Jabbari-------------------------------- ------------- ~ <br />foodat“Xr« ^xsikEnr^.n’ ktxs'J <br />SarS and operation. Return original to festival roordlnator three weeks pnorto <br />thisev-^ Jl____________owner__________ 3/20/24 <br />S<j| nature Tlt,e Date <br />Sterno w/Chaffing I — <br />Dish <br />r—J ' <br />SAN JOAOuiN <br />COUNTY <br />Greatness grows here. <br /> Ice chests S Refrigerator <br /> Refrigerated truck lce bath and tubs <br /> Other (specify). <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />0 Three compartment sink. <br />B 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 />S 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: