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Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br />aper towels and pump-style soap container. <br />13. <br />Signature Q <br />14.Completed by: <br />1 Paper Hand Towels <br />Soap dispenser <br />Cutting Board <br />Propane Stove Bleach <br />03uT <br />Rinse Water Bleach and Water <br /> Ice Cooler <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 />Sanitizer bucket­ <br />bleach & water for <br />stonng wiping cloths <br />Booth must be on <br />Concrete, Asphalt. <br />Plywood, or a Tarp. <br />5-20 Gal. <br />Hand wash Water <br />'“i <br />SAN JOAQUIN <br />— COUNTY— <br />( Extra <br />I Water <br />Propane Tank <br />Title <br />_n. <br />Soap and Water <br />Names of responsible persons to be present in booth during all hours of operation- <br /> <br /> <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 events x x <br />Date <br />'^/Vater supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />Jz^Qne separate tub (bucket or basin) for the collection of rinse/wastewater. <br />**lmportant** <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />EHD 16-02 Page 8 of 11 TEMP EVENT APR <br />07/01/2024 <br />' the f°!!Tin,9 ,“ld temPerature contral for the “W holding of potentially hazardous foods below <br />45^> (if food is used the following day, maintain below 41 °F temperature): <br />-01ce chests Q Refrigerator <br /> Refrigerated truck |Ce bath and tubs <br /> Other (specify)_______________ <br />Zx |I Fire Extinguisher <br />_____________ <br />Health Permit <br />□^hree compart fOll°tW'n^ 'temS W'thin my booth for the sanitary cleaning of food preparation utensil <br />^Three deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br />Jplption (one tablespoon of bleach per gallon of water). <br />■'C^Dgtergent, bleach, and wiping cloths (cleaning towels). <br /><3^ub to store wiping cloths in bleach solution. <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within mv <br />booth: