Laserfiche WebLink
Environmental Health Department <br />10. <br />12. <br />13. <br />A0C|-"7fe>6 '<WQ( <br />“Important** <br />14.Completed by: <br />Date <br />Paper Hand Towels <br />Soap dispenser <br />Cutting Board 1 Propane Stove Bleach <br />05Prepane Tank <br />Bleach end Water <br />Fire Extinguisher <br />z <br />Ice Cooler <br />Slemo w/Chaffing <br />Dish <br />Garbage <br />Can <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />5 Gal Hand wash <br />Wastewater Container <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping deths <br />SAN JOAQUIN <br />COUN"^ <br />Extra Ice Bags & Food Containers must be <br />stored 6 inches ottof the ground! <br />i ' '' 'J <br />Health Permit (J <br />J <br />Soap and Water Rinse Water <br />Sullen f°r S°aPy Water' °ne for ri"Si"9 and one a bleach <br />LJ Detergent, bleach, and wiping cloths (cleaning towels) <br />U Tub to store wiping cloths in bleach solution. <br />5-20 Gal <br />Hand wash Waler <br />Names of responsible persons to be present in booth during all hours of operation- <br />—IMwdo Hc.rrrtAndA? ,306t-~)w>-quoi <br />Signature <br />0 Ice chests [^Refrigerator <br /> Refrigerated truck Ice bath and tubs <br /> Other (specify)^ <br />preparation and operation. Return original to festival coordinator three weeks prior to <br />ovonte i j — * - <br /> <br />Title <br />1^ am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />Bf Water supply dispenser with warm water at a minimum of 100"F (i.e. 5-20 gallon container with spigot). <br />EJ One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Paper towels and pump-style soap container. <br />ehdw-02 Ha2elt°n AVenUe 1 Stockton- California 95205 | T 209 468-3420) F 209 464-0138 | www.sjgov.org/ehd <br />07/01/2024 P39e 8 0111 TEMP EVENT APP <br />°R EZ ThS^^ Mthln my b00th for the Sanitary cteani"9 of P Won utensil