Laserfiche WebLink
Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br />0 Water supply dispenser with warm waler at a minimum of 100’F (i.e. 5-20 gallon container with spigot). <br /> One separate tub (bucket or basin) for the colleclion of rinse/wastewater. <br /> Paper towels and pump-style soap container. <br />13. <br />"Important*' <br />14.Completed by; <br />Signature <br />r —J1' J <br />Pnx*-a tv* <br />Ice Cooler <br />PagaSofll <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 />Stc-no v-cincrg <br />Or.li <br />Garbage <br />Can <br />I am providing the following cold temperature control for tire cold holding of potentially hazardous foods below <br />45"F (if food is used the following day. maintain bolow 41*F temperature); <br /> Ice chests 0 Refrigerator <br /> Refrigerated truck Ice bath and tubs <br /> Other (specify)_ <br />Wail r—tur Canfeww <br />San.trr tiKtel- <br />& wtcr l» <br />•tavi; wiparj (Mu <br />Booih must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />SANJOAQUIN <br />-----COUNTY------ <br />Gn ern- n . ■ <br />0 <br />Title <br />Health Permit I <br />lU r <br />j <br />OaapondWoiw <br />s-ai tax <br />Hand wash WaSw <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />Q Three compartment sink. <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. <br />Names of responsible persons to be present in booth during all hours of operation: <br />J U UlxJ <br />a®K»> ord Water ____ <br />1868 E Hazelton Avenue | Stockton, Cakfoniia 95205 | T 209 468-3420 | F 209 464-0138 | www sjguv.org/ehd <br />EMO 1042 Pago a o< 11 I EM’ EVENT AFP <br />06/1W19 <br />I K <br />3U <br />I tUa lev A f ood muU bo I <br />skvW 0 rx/at idTfdtha | <br />z-s [ Fae Crtr.Jl«h« 1