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Memo w/Challing <br />Dish <br />6-20 Gal. <br />Hand wash Water <br />Paper Hang Towels <br />Sanitize!' buckei- <br />bleach &water Ion <br />storinm toiplof cloths <br />['ice Cooler <br />Fire Extinguisher <br />bate ke Dogs S Food Conlahers cruel be <br />slated 6 Inches oil of the ground! <br />6 Gal Handl wash <br />Wastewater Container <br />Gaibage <br />Can <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sjgov.org/ehd <br />END i 6-02 Page Befit TEMP EVENT APP <br />osns/ta <br />Health Permit <br />CuElmf) tionrd <br />Soap dispenser <br />Propane slave <br />Propane Tank <br />Bleach an Water <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />Soap an Water Rinse Water <br />SAN JOAUIN <br />REC-008 <br />Environmental Flealih Department <br />--COUNTY— <br />Grecitiles grows hero, <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 foliowin , maintain below 41°F temperature): <br />Ice chests Refrigerator qIc4 <br />efrigerated truck <br />ther (specify) <br />Ice bath and tubs <br /> providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />hree comparImen1 sink. <br />OR <br />Three deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br />r—ition (one tablespoon of bleach per gallon of water). <br />I petergent bleach, and wiping cloths (cleaning towels). <br />rub 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 />nNater supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />Fljne separate tub (bucket or basin) for the collection of rinse/wastewater. <br />naper towels and pumo-style soap container. <br />Names of responsible persons to be present in booth dunng all hours of operation: <br />Katlavoideee i triuti" '1C-4 VIA, My keiv- ‘Yi'vyt, <br />"Important" All food vendor booths are subject to inspection. Pleaseumake a copy of 1his 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. .Fielum original to festival coordinator three weeks prior to <br />thil event <br />1 4 . Completed by: )44Ap Ou,Pfr\e/(- 67I 2A, SUBMIT <br />Signature Title Dal