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Environmental! Health Department <br />10. <br />11. <br />OR <br />12. <br />X^] Paper towels and pump-style soap container. <br />13.Nam, <br />‘‘Important** <br />14.Completed by: <br />Title <br />Paper Hand I owels <br />Soap dispenser <br />Bleach Propane Sieve <br />0 <br />Propano Tank <br />Bleach and Water <br />fire Extinguisher <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 />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />I am providing the following cold temperature control for the cold holding of potentially hazardous foods bolow <br />45°F (if food is used the following day, maintain below 41 °F temperature): <br />^Refrigerator <br />Ice bath and tubs <br />Extra Ice Hags & l ood Containers must be <br />stored 6 inches of! ot the ground' <br />Stcrno w/Chofling <br />Dish <br />Exira <br />Water <br />Garbage <br />Can <br />Booth must bo on <br />Concrete, Asphalt. <br />Plywood, or a Tarp. <br />Ij^lce chests <br />□ Refrigerated truck <br />□ Other (specify) <br />6 Gal I land wach <br />Wastewater Container <br />Sanilizor buckot- <br />blcach & waler for <br />storing wiping cloths <br />SAN JOAQUIN <br />c ',:>u n • - <br />j Ice Cooler <br />Health Permit <br />Signature <br />2-01 <br />Rinse Water <br />l am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />Three compartment sink. <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 />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 />i^^f responsible pe^msto tjc present in booth during all hours of operation: <br />z <br />Soap and Waler <br />1 <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />El ID 16-02 Pago 8 of 11 TEMP EVEN I APP <br />06/29/2023 <br />Culling Board