Laserfiche WebLink
SAN JOAQUIN Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br />QWater supply dispenser with warm water at a minimum of 100oF (i.e. 5-20 gallon container with spigot). <br />0 One separate tub (bucket or basin) for the collection of nnse/wastewater. <br />©"Paper towels and pump-style soap container. <br />13. <br />Important** <br />Completed by:4? 2^14. <br />Health Permit <br />Poper Hand Teweb <br />Soup dnp<r<>M:< <br />Bk>.>chPn^ane Stove <br />Bleach aod WjIck <br />Fee t«t»rMShw <br />Ice Cooler <br />Q Three deep tubs (basins 6-6 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 />0 Detergent, bleach, and wiping cloths (cleaning towels) <br /> Tub to store wiping cloths in bleach solution. <br />I am providing the following cold temperature control for the cold liolding of potentially hazardous foods below <br />45T (if food is used the following day, maintain below 41 °F temperature) <br />01ce chests [ | Refngerator <br /> Refrigerated truck 0 Ice bath and tubs <br />0 Ottier (specify) <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />0 Three compartment sink. <br />5 Gal Hand wash <br />Wmlowatoi Cootoawi <br />Garbage <br />Can <br />Booth must be on <br />Concrete. Asphalt, <br />Plywood or a Tarp. <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth. <br />Slemo ■w’CruHwj <br />DW> <br />5-20 G*l <br />Hand wash Walto <br />S»>vtir«r bvctirt- <br />5*each & water Gr <br />slonng wrpviq itoths <br />E»tra <br />Wdteu <br />Tank I <br />Soap and Waler <br />/ <br />R»i»o Y?alo< <br />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 />Kl >____________________ ^<7 J 2 <br />Signature Title Date <br />f«(re/,<, Huyi «/<*»/Confa«ars meW tx» H <br />sfored 6 »>c/>«i<W<rffha ground’ ■ <br />1868 E. Hazelton Avenue | Stockton. California 95205 | T 209 468-3420 1 F 209 464-0138 I www.stgov.org ehd <br />Names of responsible persons to be present in booth during all hours of operation: <br />n J Tn, p-tcVi f ^7 /