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10. <br />u/ <br />11. <br />OR <br />12. <br /> One separate tub (bucket or basin) for the collection of rinse/wastewater. <br /> Paper towels and pump-style soap container. <br />13. <br />14.Completed by: <br />1 <br />Paper Hand Towels <br />Soap drsgenser <br />Cutting Soard <br />BlcacfiPropone Stove <br />I <br />Frwane rank <br />Bf-aach and Water <br />f-r? trxhrgitvTef <br />D U 0 <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> Three compartment sink. <br />Steroo w'Chatling <br />Dish <br />Garbage <br />Can <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />—HP <br />les daps & Food Coetsxws r.TjiI bo <br />s^beva 8 eicbcs affo^ trap ground,' <br />5 Gal Handwash <br />WiKlPABtor Cordairor <br />5-20 Gsl <br />h land wash Water <br />San.izer bucKeP <br />bteach i water for <br />scaring wpinq du-^s <br />I am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br />45OF (if food is used the following day, maintain below 41 °F temperature): <br /> Ice chests Refrigerator i j <br /> Refrigerated truck Ice bath and tubs Z7 <br /> Other (specify) <br />one for rinsing and one for a bleach <br /> Of <br />Ice Cooler <br />Health Permit <br />Date <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 /> <br />Title <br /> Three deep tubs (basins 6-8 inches minimum), one for soapy water, j.one f <br />solution (one tablespoon of bleach per gallon of water). Ny/T <br /> Detergent, bleach, and wiping cloths (cleaning towels). <br /> Tub to store wiping cloths in bleach solution. <br />7 <br />Rinse Waler <br />-----COUN^V- <br />**lmportant** <br />TT : I <br />1 <br />Soap ano Water <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />boo,h: <br /> Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />Names of responsible persons to be present in booth during all hours of operation: <br />k V <br />1868 E. Hazelton Avenue | Stockton, California 95205 j 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?29?2023 <br />Signature