Laserfiche WebLink
Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br />0 Water supply dispenser with warm water at a minimum of 100°F (i.c. 5-20 gallon container with spigot). <br />M One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />0 Paper towels and gump-stylo soap container. <br />13. <br />“Important** <br />Owner14.Completed by: <br />TitleSignature <br />1 <br />]Paper I land I owols <br />Soap disponsor <br />Cuitlnfl Board 1 /■ <br />BloachPropano Stovo <br />tjlcncli and Water/Rlnsn Water <br />Ice Cooler i : <br />i <br />L.1 <br />Soap and Wntor <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />Q 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 />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 [J Ice bath and tubs <br />[71 Other (specify) Honey doos not require heating or cooling. <br />Stoma w/CI infflng <br />Dish <br />fixlra <br />Waler <br />5 Gal I land wash <br />Waslowatnr Conlaims <br />S-20 Gal. <br />I land wash Water <br />Sanilizor txicknl- <br />bleach & water lor <br />storing wiping cloths <br />Uoolh must bo on <br />Concrete. Asphalt. <br />Plywood, or a larp. <br />Names of responsible persons to be present in booth during all hours of operation: <br />Luis Flizondo and Rita Perez <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> Three compartment sink. <br />1868 E. Hazelton Avenue | Stockton. California 95205 | T 209 468-3420) F 209 464-0138 | www.sjcehd.com <br />monio? Pageaotit rrMPLViNi app <br />07/3/17 <br />Garbage <br />Can <br />Health Permit <br />SAN JOAQUIN <br />C< >U M I Y <br />riro l.xtlnsiuishrir | <br />'■■■• ,l-i.n ig <br />I »bn Ico [iii'js & I ood Coirinittots rniisl bo j <br />stored 6 inchos oil ol the gnumrl1 <br />j Propano I'ai’k <br />5/31/24 <br />Date <br />All food vendor t/oo\hs arc subject to inspection. Please make a copy of this application in <br />preparation for /his/ event. A copy of this checklist must bo in the booth at all hours of <br />preparation ana operation. Return original to festival coordinator three weeks prior to <br />this event.. ,r