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9/8/25, 9:19 PM lmage_250905_172731 .jpeg <br />Environmental Health Department <br />OR <br />12. <br />soap container. <br />13. <br />•important** <br />14. <br />Date <br />Health Permit <br />Soap dtaptnw <br />CUftoBowd <br />PnwMttM <br />ftopaaaTaak <br />RraExflnaMMr <br />ice Cooter <br />WM&HatefonAvenue) Stockton,CaHfomia85205) T 206 468-34201 F 209464-0138 <br />https://mail.google.com/mail/u/3/#inbox/QgrcJHsbjCmDKPQxNdfzLSntjqXNBGSbSLQ?projector=1 1/1 <br />TnSEtfila <br />•: <br />SiMnov^Oiaffing <br />OW> <br />5-20 Gai. <br />Hmdwuh Water <br />B' <br />BGriHgndwah <br />Gartug* <br />Can <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />S^Vater supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />O^Qne separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Q^aper towels and pui <br />Title <br />BtMchandWteK I [ <br />11. lam providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> Three compartment sink. <br />| Btoech <br />...... <br />■ ■ - <br />SANJOAOUIN; —c ° u N T Y— <br />10. <br />g*»fcy.*p* wcmmwr iimf ttntfAtawortftoparai <br />Booth must be on <br />Concrete, Asphek, <br />Plywood, are Terp. <br />*Riu. ,■>----- |' , „,nri <br /> Three deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a Weach <br />solution (one tablespoon of bleach par gallon of water). <br />E^beteipent, bleach, and wiping cloths (cleaning towels). <br /> Tub to store wiping cloths In bleach solution. <br />fcWmd Water HmaWater <br />Names of responsible persons to be present In booth during all hours of operation: <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 aH hours of <br />preparation and operation. Return original to festival coordinator three weeks prior to <br />tola event <br />Completed by: <br />u Signature <br />•-----COUNTY----- <br />!'V- <br />I providing the following cold temperature control for the cold holding of potentially hazardous foods below <br />45T (if food Is used the following day, maintain below 41’F temperature): <br /> ice chests Refrigerator <br />O Refrigerated truck Ice bath and tubs <br />noftrarfspecfty) N■ ----------------------------------------------