Laserfiche WebLink
Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br />13. Names of responsible persons to be present in booth during all hours of operation: <br />Completed by:14. <br />Signature <br />I <br />I’ropatio Stove <br />3 l iro r-xtlnntiishor <br />Ice Cooler <br />II MPI-VnNTAPI’ <br />r ] 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 />| | fub to store wiping cloths in bleach solution. <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />| I Three compartment sink. <br />Storiio w/Chnfflng <br />Dish <br />l-xtrn <br />Wnfor <br />!> Gul I land wash <br />Wnstowalor Container <br />5 20 Gal. <br />Hand wash Water <br />Garbage <br />Can <br />Booth must l>o on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />Water supply dispenser with warm water at a minimum of 100T (i.o. 5-2.0 gallon container with spigot). <br />One separate tub (bucket or basin) for the collection of rinsc/wastewater. <br />UJffcaper towels and pump-stylo soap container. <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />lixlm lea Dags H l oad Contalneis must bo <br />stated 0 Inches oil al the gioimdl <br />SAN JOAOUIN <br />C.OUN I Y <br />(. i .•<;i -cs ■> nr •, hi < .■ <br />I am providing (ho following cold temperature control for the cold holding of potentially hazardous foods below <br />45T (if food is used the following day, maintain below 41T temperature): <br />| J Ice chests LI fRefrigerator <br />| | Refrigerated truck Ice batli and tubs <br />Cl Other (specify)_— <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420) F 209 464-0138 ( www.sjcehd.com <br />|-:i IO 16-02 P.190 0 of 11 ! T"!‘ T.VfLNI <br />07/3/17 <br />**lmportant** <br />__ ____________________________________________________________________________ <br /> <br />All lood^ondor 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 aud-operation. Rctum original to festival coordinator throe weeks prior to <br />tyTTT 7'3^ </ <br />Title Date 7 <br />| Piopniio Tnnk <br />iWr <br />Health Permit « <br />| Culling IJonid <br />[ I’npw I land Towels <br />Snnltlzor bucket- 1 <br />bloadi A water for <br />storing wiping dotlis <br />Soap disporisor <br />Soap and Water