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10. <br />11. <br />OR <br />12. <br /> Paper towels and pump-style soap container. <br />13. <br />“Important** <br />Completed by: 14. <br />■Signature <br />Paper Hand Toswls <br />Cut. ng Board <br />Prepare Sio-.o <br />I <br />Propana Tanx <br />B'oach and Walor <br />F>ro ExUngulaher <br />TEMP EVENT APP <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 rinse/wastewater. <br />St«mo <br />OH <br />Garbage <br />Can <br />Booth must be on <br />Concrete, Asphalt. <br />Plywood, or a Tarp <br />5 Gal Hand wash <br />Wastowoter Container <br />Sn-nzorb-arkct <br />Neath 4 wote; r<x <br />iturtng wV«5j (Solns <br />Health Permit « <br />Environmental Health Department <br />{ Extra A <br />Water I <br />£*/'« Im fiaoa a, Food Cnntalrws moat bo <br />storod 6 mctuos ottottha ground’ <br />__1 <br />Soop and Water <br />Name^^e^onsib^^sons^be^present in booth during all hours of operation: <br />■'i-J <br />| Ice Cooler ’ <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.orq/ehd <br />Pago 8 of 11 TEMP EVENT Al <br />IF <br />Rinse Water <br />S-20 Gel. <br />Hand wain Water <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 evegt-^—^—_ <br />3 3. <br />Date <br />SAN JOAQUIN <br />-—COUNTY <br />;:'C<l(r<<55 qt :t hri’-1 <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 /> Ice chests [Refrigerator <br /> Refrigerated truck Ice bath and tubs <br /> Other (specify) <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />lamjirovlding the following Items within my booth for the sanitary cleaning of food preparation utensil <br />(^Three compartment sink. <br />O 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 />Q Tub to store wiping cloths In bleach solution. <br />Z*~ CXyU - <br />Title <br />| Soap rt j <br />Bloach