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Rinse Water <br />Stern, w/Chalfing <br />Dish <br />5-20 Gal. <br />Hand wash Water <br />Paper Hand Towels <br />Sanaiwr btx-iiet- <br />b'each &waterier <br />&bring roping ctihs <br />Booth must boon <br />Concrete, Asphalt <br />Plywood, or a Tarp. <br />r <br />Ice Cooler <br />Fire Edinguither <br />F Ye B Co Ea Sops 11 ood n7 -7 L allers must be <br />sxvect 6 inches ott DI the amend! <br />I <br />Bleach and Wafer Garbage <br />Can <br />Li I <br />Cu tag 80.aid <br />Propane Stove <br />Propane Tank <br />Soap dispenser <br />Soap and Water <br />Health Perm <br />5 Gal Hand trissh <br />Waster oter Conthiner <br />(,f9iff,e?cos, SAN JOAQUIN <br />ilaTtillr c N T <br />••urecitness grows here. <br />R EC-008 <br />Environmental Health Department <br />I am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br />°F (if food is used the following day, maintain below 41°F temperature): i [t <br />Ice chests Refrigerator <br />lam providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />Three cornpartment sink. <br />hree deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br />on (one tablespoon of bleach per gallon of water). <br />tergent, bleach, and wiping cloths (cleaning towels). <br />ub to store wiping cloths in bleach solution. <br />I arn providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />pater supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />E)ne separate tub (bucket or basin) for the collection of rinse/wastewater. <br />i, <br />efrigerated truck <br />her (specify) <br />ce bath and tubs <br />4-C //C (63/97/11,4i <br />OR <br />13. <br />'aper towels and pump-style soap container. <br />Names of responsible persprks to be present in booth Owing all hoyrs of operAtion: <br />.)-5A-4)51/1 t.4 /5114 -e_5/' 4-0 — <br />**Important** All food vendor booths are <br />preparation for this event. <br />preparation and operation. <br />this eventi, <br />14. Completed by: /7 ri4Ail,f7f-l i <br />Signature <br />subject to inspection. Please make a copy of this application in <br />A copy of this checklist must be in the booth at all hours of <br />Return original to festival coordinator three weeks prior to <br />Title <br />S-. 1 2 Y <br />Date <br />SUBMIT <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sigov.orglehd <br />[11) 16-02 Page8of 11 TEMP EVOYT APP <br />08i15'10