Laserfiche WebLink
s.?ii Gal <br />Ilmnd wantil Watew <br />Propane Stove <br />Soap dispenser <br />Steno yr/Chaffing <br />Dish <br />Ice Cooler <br />II Ertra h-.e Bags & Food Cnetemers must be <br />stored 6 Inches oft el the ground! <br />Garbage <br />Can <br />Health Permit <br />Cutt, op Boar <br />Paper Hand Tavials <br />Sanitize, bucicel- <br />bleach 8 wale, for <br />storing wiping cloths <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />SAN JOAQUIN <br />COL; N I Y <br />Environmental Health Department <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 />LI Ice chests ZiRefrigerator <br />0 Refrigerated truck 0 Ice bath and tubs <br />0 Other (specify) <br />I a providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />1611 Three compartment sink. <br />El Three deep tubs (basins 6-8 inches minimum), one for soapy water, one for nnsing ano one for a bleach <br />solution (one tablespoon of bleach per gallon of water). <br />El Detergent, bleach, and wiping cloths (cleaning towels). <br />0 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 />RfWater supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />EI One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />CI Paper towels and pump-style soap container. <br />Names of responsible persons to bc present in booth during all hours of oporation: <br />I • • •CO • I <br />(AAA Co)ogralet, avirA ManiZs.1 EtAiT5Ark 1247dirr:biLT C.:110.(4- Writ, DLL e Slain PigarejiLL S; irt: kim4 <br />"Important" 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 and operation. Return original to festival coordinator three weeks prior to <br />this event. <br />et— 5fttes- ibor Ctorai4okoe 31/423 <br />Signature Title Date <br />OR <br />• . S. _ <br />14. Completed by: <br />Coh.rieS <br />r 4.; <br />1868 E. Hazelton Avenue 1 Stockton, California 95205 I T 209 468 34201 F 209 464 -0138 1 www.sicehd.corn <br />END 16-02 Page 6 of 11 TEMP EVENT APP <br />07/3/17