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Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br />Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-2.0 gallon container with spigot). <br />fyfOno separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Paper towels and pump_-style^pap. container. <br />13. <br />"‘Important** <br />14.Completed by: <br />IPapor I lurid Towob <br />I- <br />| Dloacli <br />AW <br />II Ini Pxtlnwtibhor <br />Ice Cooler <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />!> Gal I hind wash <br />Wastewater Cnatelnor <br />6-20 Gal. <br />Hand wasli Water <br />Garbage <br />Can <br />Sanitlznr buckot- <br />bloach A water for <br />storing wljilng cloths <br /> Boolh must bo on Concrcto, Asphalt. <br /> Plywood, or a Tarp. <br />/ x/ra Ice Hags & I ooit Conlalneis musl bo <br />stated 6 Inches ell ot the groundl t, <br />1868 I.:. I lazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjcehd.com <br />1110 10-02 PagoOofll rf-MI’l VI Nl API’ <br />0//3/IZ <br />| | KinrinWatnr | | I Munch and Water <br />/^Oxtrn^ <br />I Water <br />All food vendor booths arc 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 />Sign afore <br />SANJOAOUIN <br />COUNTY <br />(■» ••(»( f'r:'*• ini'i'--. /)<-!<• <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 |“l Refrigerator <br />0 Refrigerated truck Q Ice bath and tubs <br /> Other (specify) <br />Title <br />| I loalth Permit I <br />Names of responsible persons to bo present in booth during all hours of operation:. JVZ/a 1)_ J___ _ ___________ <br />| So«p dltponsor <br />| i 'roixuio Tank <br />| I'rop.nio Slovn <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />KI Three compartment sink. - feh VAt <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 />LI Tub to store wiping cloths in bleach solution. <br />| | Soap and Water | <br />| CuMum Board <br />Slnrao w/Chnffino <br />Di.ili