Laserfiche WebLink
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/wastewater. <br />13. <br />Completed by:14. <br />Date <br />Paper Hand Towels <br />Soap dispenser <br />BleadiPropane Slove <br />Fire Extinouisher <br />TEMP EVENT APP <br />5 Gal Hand wash <br />Waste water Container <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping cloths <br /> Booth must be on <br />Concrete, Asphalt, <br />Plywood, ora Tarp. <br />I am providing the following for adequate hand washing facilities,-but separate from utensil wash within my <br />booth: <br />Stemow/Chaffing <br />Dish <br />5-20 Gal. <br />Hand wash Water <br />Extra <br />Water <br />Garbage <br />Can <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 /> <br />' Signature <br />Extra Ice Bags S Food Containers must be <br />stored 6 inches oft of the ground' <br />Title <br />Health Permit <br />/ <br />Rinse Water <br />Paper towels and pump-style soap container. <br />Names of responsible persons to be present in booth during all hours of operation: <br />5C.QTT- <br />< ...' .- 7 <br />Soap and Water <br />Propane Tank <br />[|l <br />Ice Cooler <br />**lmportant** <br />x. SANJOAQUIN <br />' ------COUNTY------- <br />F.Grectness grows here. <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 /> Ice chests Refrigerator <br /> Refrigerated truck Ice bath and tubs <br />Toother (specify) <br />I gm providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />jS<£hree 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 />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420) F 209 464-0138 | www.sjcehd.com <br />EHD 16-02 Page 8 of 11 TCZP CVZt <br />07/3/17