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*$ <br />Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br />1^ 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 />‘‘important** <br />14./DateTitle <br />I Pap«r Hand Towels <br />Soap dispenser <br />Cutting Coaid <br />Bleach <br />Propane Stove <br />I [E <br />=l <br />Fife Extinguisherf <br />Ice Cooler <br />MJ <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />Extra Icg Bags & Food Containers must be <br />stored 6 incites off ol the grotmcF <br />Siemo w/Chatfog <br />Dish <br />Eiira <br />Water <br />Garbage <br />Can <br />Booth must be on <br />Concrete, Asphalt. <br />Plywood, or a Tarp. <br />5 Gal Hand wash <br />Waslewater Container <br />5-20 Gal. <br />Handvrash Water <br />Sanitizer bucket­ <br />bleach R water for <br />storing v/plng cloths <br />' 7 <br />Soap and Water <br />r <br />Rinse Water <br />Propane Tank <br />1868 E. Hazelton Avenue | Stockton. California 952051^209468-34201 F 209464-0138 | vrvrw.sjcehd.com <br />EHD lfl-02 <br />07/3/17 <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> Three compartment sink. <br />iMj 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 />13 Detergent, bleach, and wiping cloths (cleaning towels). <br />1X1 Tub to store wiping cloths in bleach solution. <br />Paper towels and pump-style soap container. <br />Names of responsible persons to be present in bgoth during all hours of operation: <br />y VI^iaz y ____________ <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 />Completed by: ----------------//fyk/3 <br />' Signature Title 'bate <br />| ^^H^Th^Perr^T^ <br />7'7 \ SAN JOAQUIN <br />'------COUNTY------ <br />' < <■ <r< C / c o / < > p \ s t| /• o tv $ A t? re. <br />1 arr,oProv'ding 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 Q Refrigerator <br /> Refrigerated truck Ice bath and tubs <br /> Other (specify)