Laserfiche WebLink
<br />Environmental Health Department <br />Nk 11. <br />OR <br />12- <br />13. <br />14. <br />Maol Turt-M <br />J'rnjutirt 3»wa <br />ProaouTHfi <br />Btaadi pr»l W/tef <br />[jn=E>rtr<J<*=r«r <br />Health Permit h <br />t=Xixi- <br />H-«hA«=eTib- fc'nrtm-jwIpUjjCtrjer. <br />, -r^ ' <br />SGMH'trri^adl <br />WjiiU^uiw <br />Slesmu tsitiKiHaS <br />f&fa <br />Catrbagc <br />Can <br />aoatti intiyt be on <br />Koncjeie, Asphalt, <br />Plywood, nr a Tarp. <br /> Paper towels and num&-siyie soap container. <br />Names of responsible persons to be present in booth during all hours of operation: <br /> <br />"•trnporfanf*" <br />'Jmp nspawi j <br />fftKEh <br />I Erira>sfl*?x 4 Food Ccrtaiw/s tivai t« <br /> <br />18158 E. Melton Avenue | Stockton, California 96205 | T 209 468-3420 I F 209 464-0138 | <br />fiHD ! B-02 <br />ns/tfi/ie <br />s-zj ra». <br />y- M*«S iranh Water <br />Oo.yvscv^ <br />Signature <br />£:. <br />jjce Cooler”] j <br />3EZZZ <br />ftteeak* <br />...... COUNTY . <br />1 ^a’FfitfSn u n^ir'^.r0*11 leimP6ral.uro control for lhe cold hoWIng of polwiltally heasretOB foods below <br />- VI1000 L, used tlw totlowhio day. maintain below 41 ■? lemperatura): <br />Mloeohests □Rofrtfloralor <br />BRofrigorated truck I® talk and tubs <br />® Other (sp©Pify)____ ___.___ _ *________________________ ____________ <br /> Three deep tubs (basins 6-0 inches minimum), one for soapy water, one frx rinsinfl end one for a bleach <br />solutton (one tablespoon of bleach por gallon of water). <br />O Detergent, bleach, and wiping cloths (cleaning towels). <br />Q Tub to store wiping cloths in bleach solution. <br />I am providing the following for adequate hand washing facilities, but separate from utonsll wash v/ithln my <br />booth: <br />Water supply dispenser with warm water al a miriimiim of 100"F (le. 5-20 galton container with spigot). <br />[sj One separate tub (bucket or basin) for lhe collection of rlnse/wastewater. <br />lam providing tho following items within my booth lor too eanltery cleaning of food preparation utensil <br /> Three compartment sink. <br />6cot> irtd Wjaoe <br />.... ____________________—--------------------------------------------- <br />^i5Ay:foodvend£^ootte are subject to inspection.. Please make a copy of tots appSc<riK>n m <br />preparation for this event A copy of this checWit must ba in too booth at afi hours of <br />preparation and operation. Retore origfoal U> festival coordinator three prior to <br />tfds event, » f. ,. / L z <br />Completed by:----------