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<br />08-28-2024 <br /> <br />Title Date <br />or <br />Soap and Water Rinse Water <br />5 Gal Hand wash <br />Wastewater Container Extra Ice Bags & Food Contatners must be <br />stored 6 inches off of the ground' <br />1 <br />Ice Cooler <br />Cutting Board <br />Propane Stove <br />// <br />Sanitizer bucket- <br />bleach 8 water tor <br />storing wiping cloths <br />Bleach <br />// <br />Booth must be on <br />Concrete. Asphalt. <br />Plywood. or a Tarp. I <br />Fee Extinguisher <br />Bleach and Water Garbage <br />Can <br />REC-008 <br />SAN JOAQUIN <br /> <br />Environmental Health Department <br />COUNTY — <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 />EI Ice chests E Refrigerator <br />Refrigerated truck Ice bath and tubs <br />Other (specify)LARGE ICE CHEST <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />EI 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 />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />One separate tub (bucket or basin) for the collection of rinseiwastewater. <br />Paper towels and pump-style soap container. <br />Names of responsible persons to be present in booth during all hours of operation: <br />NICOLAS, STEVE, JUAN SANCHEZ <br />HELP COOKS ESTEBAN, MONICA, MARIELA, BRYAN, CARMEN <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 />thi s event. aSIgnetlyta <br />aer_A(5'So b rgasai ..935141(f.121,1.5 <br /> <br />5-20 Gal <br />Hand wash Water <br /> <br />Health Permit <br /> <br />S[erou w Chalfing <br />DIsh <br /> <br />Paper Hand Towels <br /> <br />Soap dispenser <br /> <br />OR <br />14. Completed by: <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sjgov.orgehd <br />EHD 16-02 Page 8 of 11 TEMP EVENT APP <br />061 919