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9- - ■ <br />Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br />p^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-stvte soap container. <br />13. <br />**101 portant** <br />14.Completed by: <br />I Paper Hanc Towels <br />Soaptfapcrrerr <br />Coifing Boa rtl <br />BScsdiPropane SUM <br />it -A? <br />Propane Ter* <br />■)Rtaxcti ztdWatsSoapewlWgter <br />Fire fixtingicSscr <br />Ice Cooler <br />1868 E. Hazelton Avenue j Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | wv7w.sjgov.org/ehd <br />EHD1SXJ2 PagoSotl! TEMP EVENT APP <br />06/ 2QI2023 <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> Three compartment sink. <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />Garbage <br />Can <br />fcs Bags a Food Coatancrs Oital ba <br />atotbd 6 iwnes eS oi tn® srewtt! <br />$Ga Hand wash <br />WtabjMgler ContanTW <br />&20 Gal. <br />Hand wash w»«f <br />Sanitizer buck o'.* <br />btad'4 w«er5or <br />storing wrpbng dslhs <br />BoolTi must be on <br />Concrete, Aspnait, <br />Plywood, or a Tarp. <br />Health Permit I <br />Extra <br />Vffttit <br />Stems w/Charftro <br />Dish <br />SAN JOAQUIN <br />--COUI\TV----- <br />Trtle <br />RErtM-WaW <br />Names of responsible persons to be present in booth during all hours of operation; <br />_________________________ <br />:L <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 />thiseyent------- <br /> <br />Dare 'z Signature <br />ftf^hree 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 />0 Detergent, bleach, and wiping cloths (cleaning towels). <br />J^"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 />gpTce chests Refrigerator <br /> Refrigerated truck Ice bath and tubs <br /> Other (specify) ______________________—------------------------