Laserfiche WebLink
Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br />13. <br />14.Completed by; <br />Signature <br />Health Permit <br />Paper Hand Towels <br />Soap dispenser <br />Cutting Board <br />BleachPropane Stove <br />n <br />Propane Tank <br />Bleach and Water <br />Fire Extinguisher <br />I! <br />EHD 16-02 <br />06/29/2023 <br />Extra <br />Water <br />5-20 Gal. <br />Hand wash Water <br />Garbage <br />Can <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />Extra Ice Bags & Food containers must be <br />stored 6 Inches otto!the ground! <br />Sterna w/Chaffing <br />Dish <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping dottis <br />5 Gat Hand wash <br />Waatowater Container <br />Ice Cooler <br />__________i <br />Title <br />z <br />Soap and Water <br />^Important** <br />xpy |&b <br />Date <br />_z <br />Rinse Water <br />^Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />O One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Paper towels and pump-style soap container. <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 event <br />SAN JOAQUIN <br />------COUNTY------- <br />Grc-orness j/qws <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 />Q Ice chests Refrigerator <br /> Refrigerated truck |Ce bath and tubs <br />tS. Other (specify) f-OYY^ VY) P/l Z~_______________________________________ <br />Names of responsible persons to be present in booth during all hours of operation: <br /> <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />- - - -2 Page 6 of 11 TEMP EVENT APP <br />lam providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />LWlhree compartment sink. <br />El Three deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br />solption (one tablespoon of bleach per gallon of water). <br />Hpetergent, bleach, and wiping cloths (cleaning towels). <br />LMTub to store wiping cloths in bleach solution. <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: 1