Laserfiche WebLink
` 2 o. SA N J UA Q U I N Environmental Health Department <br /> COUNTY <br /> _,cos Greatness grows here. <br /> 10. I am providing the following cold temperature control for the coil holding of potentially hazardous foods below <br /> 45°F(rf food is used the tnliowfng,d._ayafntaln below 41 OF temperature); <br /> g�f chests Refrigerator <br /> ezerated truck ❑ Ice bath and tubs <br /> ❑Other(specify) <br /> 11. SThree <br /> providing the following items within my booth forthe sanitary cleaning of food preparation utensil <br /> compartrnent sink. <br /> OR <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 /> 12 1 am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br /> booth: <br /> &�4/Water supply dispenser with warm water at a minimum of 100°F(i.e_5-20 gallon container with spigofl_ <br /> �7rQ separate tub(bucket or basin)for the collection of rinse/wastewater. <br /> Paper towels and pump-style soap container_ <br /> 13. Names of responsple persons to be present In oth during all hours of operation: <br /> '°`Impor�e�rt" Aft food vendor booths are subject to inspection. Please make a copy of this appficapon in <br /> preparation for this event A copy of this checklist must be in the booth at all hours of <br /> preparation and o lion. Return ari final to festival coordinator three weeks priorta <br /> this event �/ <br /> 14_ Completed by: nL�� ri cc R • 8q 11 Y <br /> ignaturae Title <br /> 5-20 caL <br /> Health Permit Hand vms'ftftr <br /> �wa>�rmo <br /> Dew Paper Hand TorteLs <br /> Soap dksponaer <br /> CultM Board Sankkw bucket- <br /> tAeactt$%QW for <br /> slunng <br /> Propane Score <br /> Bleach �a dolls <br /> DDtltt'1 Must be W <br /> C icrete,Asphalk <br /> Piywood,or a Tarp. <br /> Soap and Wahu Bleach and Water Gs,y,o„e <br /> Can <br /> Rre F�Qinpufsha <br /> Fxfii <br /> YJaler <br /> -1� <br /> 00, <br /> Ice Cooler 5 Gal Hand waah <br /> aft lop flap.6 Food Comte W"mast ba MUONwter Canralaer <br /> sued B fiches off or the Wmm l <br /> 1868 E. Hazelton Avenue 1 Stockton, California 95205 T 209 468-3420 1 F 209 464-0138 l www.sjgov.org/ehd <br /> EHD 1"2 Page 8 of 11 T AtP EVENT <br /> 07A1f202S <br />