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Environmental Health Department <br />11. <br />OR <br />12. <br />13. <br />Completed by: 14. <br />Signature <br />Health Permit 1 Papw Hand l owais <br />60ppWKlW»!<'r <br />PnuanoHI <br />IjQj/Vater supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />f~l One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Sidinb w/Clialfina <br />Olsh <br />SarJ.tior budu4- <br />Meotiitv/a’.er <br />slating w^ntl cMMs <br />[ nofl<d | <br />Propano Sloizc ~ <br /> <br />p<owneTai*.^ <br /> Paper towels and pump-style soap container. <br />FJajnes of responsible persons to be present iri booth during all hours of operation: <br />Jfe4r!^)V\ _ <br />‘important** <br />Garbuge <br />Can <br />Booth must he on <br />Concrete. Asphalt. <br />Plywood, or a Taip. <br />10. <br />l l FiroCxCnfM*'!*-’! <br />6 20 Gd. <br />y Hund vniili Waler <br />j Scap<n«pw.ar | -------- \ <br />1 <br />QF. .. | <br />fill <br /> Three deep tubs (basins 0-R 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 for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <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 andoparatlon. Return original to festival coordinator three weeks prior to <br />?/k/^ <br />Title Date <br />)C<I 4 food ConMw* Iin»l i>B <br />iloted 0 lr,ciivi Mollhv uiouirJI <br />1fi68 E. Hazelton Avenue | Stockton, California 96205^1 T( 209 468-3420 | F 209484-0138 | w^'S^ehd.com <br />07/3/17 <br />HlnsnWntiVQ <br />pepIHwidwush <br />WfllioWHiorCoiilwnQr <br />[ IMnuchBiidWW I I <br />SAIWDAOUIN <br />_ ... ‘ ------COUNTY <br />^fpritnvSs ycotv'; here, <br />1 am providing the following cold temperature control for the cold holding of potontlally hazardous foods below <br />45"F (if food is used the following day, maintain below 4 TP temperature): <br /> Ice chests Refrigerator <br /> Refrigerated truck Ice bath and tubs i <br />f^Other (sneclfy) 'iVt\CVCa..L _____________________,_______________ <br />I am providing the following items within my boolh for the sanitary cleaning of food preparation uterifelj <br /> Three compartment sink. <br />nioncli kli