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Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br />EJ Paper towels and pump-style soap container. <br />13. <br />14.Completed by: <br />Paper Hand Towels <br />Soap dispenser <br />Cutting Board <br />3Propane Stove Bleach <br />0 <br />Propane Tank <br />Rinse Water Bleach and Waler <br />Fire Extinquisher <br /> <br />Extra Ice Bags & Food Containers must be <br />stored 6 inches off of the ground! <br />Sterno w/Chaffing <br />Dish <br />5 Gal Hand wash <br />Wastewater Container <br />Garbage <br />Can <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping cloths <br />5-20 Gal. <br />Hand wash Water <br />SAN JOAQUIN <br />- COUNTY- <br />_______- <br />Health Permit I <br />__1 <br />Soap and Water <br />1868 E. Hazelton Avenue | Stockton. California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />Pa0e 8 of 11 TEMP EVENT app <br />07/01/2024 <br />Ice Cooler <br />lam providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />[Yj Three 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 />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 />I Signature Title Bate <br />Names of responsible personate be present in booth duringrall hour? of operation: <br />_KAJ IWfYuAdxvq./ 6 eye /nWv»A <br />**lmportant’ <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: 7 <br />Heater supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />Q One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />1 '"3 the fo"owin9 cold temperature control for the cold holding of potentially hazardous foods below <br />4b i- (it rood is used the following day, maintain below 41 °F temperature): <br />CZI Ice chests Q Refrigerator <br />^Refrigerated truck |Ce bath and tubs <br /> Other (specify)