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Environmental Health Department <br />d <br />OR <br />12. <br /> One separate tub (bucket or basin) for the collection of rlnse/wastewater. <br />13. <br />‘‘Important** <br />14.Completed by: <br />Titleifg\ a ture <br />Health Permit <br />p»p«r HandTowdi <br />Culling Hoard <br />Propano Slava <br />u <br />Propano Tank <br />Pleadi and Waler <br />FIro ExUngulihtr <br />Ice Cooler <br />TEMP EVENT APP <br />I <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />bOOth: . i|. <br />imowfChainng Olih <br />BGalHMdwaih <br />WoilawatorContolnar <br />Garbage <br />Can <br />SanllUar bucktl- <br />bleach & walar for <br />alortngvXpIngclolhi <br />Booth must be on <br />Concrete. Asphalt, <br />Plywood, or a Tarp. <br />extra <br />Walar <br />Etlrt ka Bags A Food Containers musl bo <br />slond t Inchas oil ol Ilia gmindt <br />z <br />Soap and Walar RlnsaWalor <br />1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 | F 209 464-0138 | www.sjcehd.com <br />EHD 16-02 Pago 8 nF 11 TEMP EVEHI <br />07/3/17 <br /> Paper towels and pump-style soap container. <br />Najsor^ogbleall hou^ytcVlg'j <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 jmell -u2z-&7 23 <br />thia uatef r <br /> Water supply dispenser with warm water at a minimum of 100"F (i.e. 5-20 gallon container with spigot). <br />6-20 Gal. <br />r- Hand «rt>Jh Walar <br />| Soap dlapanter | \ <br />r <br />SAN JOAQUIN <br /><> Ity ;• -1 ------COUNT Y------- <br />\ A?,._ <br />'nor'''7 GreiilncbJ ipoivs ln/re. <br />10. lam 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 />11. lam providing the following Items within my booth for the sanitary cleaning of food preparation utensil <br /> Three compartment sink. 1 <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). <br /> Detergent, bleach, and wiping cloths (cleaning towels). <br /> Tub to store wiping cloths In bleach solution.