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aboutblankFirefox <br />f <br />Environmental Health Department <br />1 <br />11. <br />OR <br />12. <br /> Paper towels and pump-style soap container. <br />13. <br />14.Completed by: <br />Paper I i.ind 1 oweli <br />I BMpdiipenSM j <br /><1 <br />nioadi and Waler <br />Fira Gxllnoulsher <br />i o«^„i,i^>, nmnr, i t ono zco q/ion I c bno -iRZ.nd nn I tAniAAr rr/'okrtA or>ci rr <br />2 of 3 3/6/2024, 11:34 AM <br />1^ <br />■ <br />i <br />Z3l <br />Snap and Waler <br />I <br />StomowlChaffing <br />Dish <br />5 Gal Hand wash <br />Wastcwslar Con'.a'ner <br />SanWror ixrcJcot- <br />bleadii waler for <br />slodog wiping efollis <br />Booth must bo on <br />Concrete. Asphalt, <br />Plywood, or a Tarp. <br />.?■ <br />1V.W j <br />( Extra \ <br />I Wulor I <br />ijM Ol X Jt <br />I jtinMWswr <br />Propano Tank <br />Ice Cooler <br />^T,' T SAN JO AOUIN <br />■ -COU NTY------- <br />Cici:<>w$ hurt\ <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 />Fl Refrigerated truck O Ice bath and tubs . i , /" , <br />Other (specify) C I (MM . WW f <br />I am providing the following Items within my booth for the sanitary cleaning of food preparation utensil <br /> Three compartment sink. N (\ <br />| Cullinp Da-itrf <br />1‘ropena Gfova ~ <br />• L■■■ <br />Names of.responsible persons to be present in bpoth durinj <br />CastiMSj , <br />“Important** <br />. r- --■’••.r-i’"''' ’ <br />10. <br />I Bleach <br />5-JO GaL <br />y- Handwash Wafor| Health Permit <br />•— <br />Garbage <br />Can <br />is within my booth for the sanitary cleaning of food preparation utensil <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). iaL> <br />Fl Detergent, bleach, and wiping cloths (cleaning towels). <br />n Tub to store wiping cloths in bleach solution. F <br />Ftlni Ico Ba^s i Food Conloinas rwsl bt> <br />slorsd a inebas oil o! Utogm'/Kll i <br />ible persons to be present in booth during all hours of operation: i <br />QV ________ <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 dpdratioru Return original to festival coordinator three weeks prior to <br />TnsoX p w 4-17^ <br />Signature Title Date <br />] <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: -4 <br /> Water supply dispenser with v/arm water at a minimum of 100°F (l.e. 5-20 gallon container with spigot). <br /> One separate tub (bucket or basin) for the collection of rinse/wastewater. Ct'