Laserfiche WebLink
SAN JOAQUIN Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br />0 Paper towels and pump-style soap container. <br />13. <br />“Important** <br />14.Completed by: <br />Health Permit <br />Paper Hand Towels <br />Cutting Board A /Propane Stove <br />Propane Jani, <br />Firo Extinguisher <br />Ice Cooler <br />0 Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />0 One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Extra Ice Bags S Food Containers must be <br />stored 6 inches o't o! the ground1 <br />Storno w/Chstfing <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 />Names of responsible persons to be present in booth during all hours of operation: <br />Andrew Osborne and/or Casey Osborne <br />5-20 Gal <br />Hand wash Water <br />Signature <br />IT <br />Rinse Water <br />CFO/Secretary/ Operator 03/05/2024 <br />Title Date <br />lam providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />M Three compartment sink. <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 evpnt. ' — <br />___L <br />Soap and Water <br />I am providing the following 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 Q Ice bath and tubs <br />Cl Other (specify) n/A for the Jerky booth _______________ <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 />M 1 <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within mv <br />booth: 1 <br />Dio?6.o2llaZelt0nAVem'e| S,ocklon- Callfoniia 95205 | T 209 468-3420 | F 209 464-0138 | www sjcehd.com <br />07/3/17 Page 8 of 11 1EMP EVENT APP <br />Extra <br />Waler