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5-20 Gal <br />Hand wash Water <br />Cutting Board <br />Propane Stove <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />Propane Tank <br />Rinse Water Bleach and Water Garbage <br />Can <br />Stemo w/Chaffing <br />Dish <br />Health Permit <br />Completed by: <br />Signature <br />Manager <br />Title <br />Ice Cooler <br />Extra Ice Bags 8, Food Containers must be <br />stored 6 inches off of the ground/ <br />5 Gal Hand wash <br />Wastewater Container <br />Date <br />Soap dispenser <br />Paper Hand Towels <br />Sanitizer bucket- <br />bleach & water for <br />storing wiping cloths <br />SANJOAQUIN <br />-COUNTY-- Environmental Health Department <br />utrtes 1rows herf. <br /> <br />10. 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 V Refrigerator <br />Refrigerated truck LI Ice bath and tubs <br />LI Other (specify) <br /> <br />11. I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />Three compartment sink. <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 />12. I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />V Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot) <br />V One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Paper towels and pump-style soap container. <br />Names of responsible persons to be present in booth during all hours of operation: <br />Doug <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 />1868 E. HazeIton Avenue Stockton. California 95205 I T 209 468-3420 F 209 464-0138 l www.sjgov.org/end <br />EHD 16-02 Page 8 of 11 TEMP EVENT APP <br />06/19/19 <br />OR