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REC-008 <br />Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br />Q Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />Q One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Q- Paper towels and pump-style soap container. <br />13. <br />03-11-2025owner14.Completed by: <br />Title Date <br />] <br />Paper Hand Towels <br />Soap dispenser <br />Cut linp Board <br />BleachPropane Stove <br />I <br />Rinse Water Bleach and Water <br />Fire Extinguishera <br />Ice Cooler <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />Extra Ice Bags & Food Containers must be <br />stored 6 inches oft of the ground! <br />Sterno w/Chalfing <br />Dish <br />Extra <br />Water <br />Garbage <br />Can <br />Sanitizer bucket­ <br />bleach & water tor <br />storing wiping doths <br />Booth must be on <br />Concrete, Asphalt. <br />Plywood, or a Tarp. <br />Q 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 />5-20 Gal. <br />Hand wash Waler <br />5 Gal Hand wash <br />Wastewater Container <br />Names of responsible persons to be present in booth during all hours of operation: <br />Samantha Nolasco <br />Faith Previtera <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. •Signod S*»ink«»aDoco.com <br />* i 7dcsc7s«so:*«3r«3si^im2tx»i?i0oiynmurt; <br />Propane Tank <br />/ <br />L <br />Soap and Water <br />| Health Permit <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> Three compartment sink. <br />SAN JOAQUIN <br />------COUNTY------ <br />Greotncss grows here. <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 />Q Ice chests Refrigerator <br /> Refrigerated truck Ice bath and tubs <br /> Other (specify) <br />1868 E. Hazelton Avenue | Stockton. California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />EHD 16-02 Page 8 of 11 TEMP EVENT APP <br />06/19/19