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SAN JOAQUIN rnvironmonUd Heiilth Dq.Mii hnent <br />10. <br />11. <br />OR <br />12. <br />13. <br />**lmportant** <br />14.Completed by: <br />Health Permit <br />Paper Hand Towels <br />Cutting Board <br />Propane Stove <br />°ropare Tanh <br />Bleach and Water <br />Fire Extinguisher <br />Ice Cooler <br />Exfre Icc Bogs & Fo-y.l Conla ws mist bo <br />stored 6 inchos off of the grow!' <br />Sterno w/Chaflmg <br />Dish <br />Extra <br />Water <br />5 Gal Hand wash <br />Wastewater Container <br />Garbage <br />Can <br />San.t^e' bucket­ <br />bleach f. water for <br />storing vzpmg cloths <br />Booth must be or <br />Concrete. Asphalt <br />Plywood, or a Tart <br />5-20 Gal <br />Hand wash Water <br />Title <br />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 />^7 <br />Scap and Water Rinse Water <br />1 ,he followi,19 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 ^Refrigerator <br /> Refrigerated truck ice bath and tubs <br /> Other (specify) <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 />prepaiation and^operation/ffieturn original to festival coordinator three weeks prior to <br />Signature Title Date <br />EU 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 />KT Detergent, bleach, and wiping cloths (cleaning towels). <br />|STub to store wiping cloths in bleach solution. <br />1868 E. Hazelton Avenue | Stockton. California 95205 | T 209 468-3420 1 F 209 464-0138 | www.sjcehd.com <br />ozS’i? 02 Pa9° 8 °f 1 ’ TEMP EVENT App <br />j^Thrleeco19p'het fol,°twin9k items within my boo,h for ,he sa,1itary cleaning of food preparation utensil <br />I am pioviding the following foi adeguate hand washing facilities, but separate from utensil wash within mv <br />booth: 1 <br />J^Paper towels and pump-style soap container. <br />Names of responsible persons to be present in booth during all hours of operation: <br />