Laserfiche WebLink
Docusign Envelope ID: 6C9D01A8-BBDF-40D8-962F-58FDEE9B039A <br />SAN JOAQUIN Environmental Health Department <br />10. <br />11. <br />OR <br />12. <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/wastewatcr. <br />□ Paper towels and pump-style soap container. <br />13. <br />“Important** <br />14. <br />Title DateSignature <br />IHealth Permit <br />Paper Hand Towels <br />Culling Board 1 BleachPropane Stove <br />Bleach and Water <br />Fire Exfnguisher <br />Ice Cooler <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />Sterne w/Chaffing <br />Dish <br />Extra <br />Waler <br />5 Gal Hand wash <br />Waslcwnlcr Container <br />Sanitizer bucket­ <br />bleach A water tor <br />storing wiping cloths <br />Booth must bo on <br />Concrete. Asphalt. <br />Plywood, ora Tarp. <br />5-20 Gal <br />Hand wash Water <br />__;> <br />a <br />r • ■ » ■ - ■■ ■ . ■ <br />l:ttra lea Bags rood Cont.ilncrs mast bo <br />stored 6 inches Otl oT the ground! <br />186H F:. Hazelton Avenue | Stockton. California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjcehd.com <br />EHD 16-02 Page 8 or 11 TEMP EVENT APP <br />07/3/17 <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 />LI Ice chests IxJ Refrigerator <br />□ Refrigerated truck I i Ice bath and tubs <br />□ Other (specify) <br />Names of responsible persons to be present in booth during all hours of operation: <br />Joe Bauer, Justin Gaytan, Jorge Lara <br />H 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 />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />LJ Three compartment sink. <br />All food vendor booths arc 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 />Completed by:! • ^15/2025 <br />J •lio|>.ir'<> Tank <br />Rmsc Water | <br />| Soap dispenser <br />Garbage <br />Can <br />7 <br />Soap and Water