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Environmental Health Department <br />- f <br />10. <br />11. <br />OR <br />12. <br />13. <br />“Important** <br />Completed by: 14.DateSignature <br />Health Permit <br />Paper Hand Towels <br />Soap dispenser <br />Cirtting Board <br />Bleach <br />Propane Stove <br />itit <br />Propane Tank <br />Ice Cooler <br />Garbage <br />Can <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />Extra tee Bags & Food Containers must be <br />stored 6 inches off of the ground! <br />Sterno w/Chatfng <br />Dish <br />5 Gal Hand wash <br />Wastewater Container <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping cloths <br />z <br />Soap and Water Rinse Water <br />( Extra \ <br />Waler I <br />my booth for the sanitary cleaning of food preparation utensil <br />1868 E. Hazelton Avenue | Stockton, California 95205IT,209 468-3420 | F <br />EHD 16-02 <br />07/01/2025 <br />hd <br />1^. I Fire Extinguisher <br />5-20 Gal. j <br />Hand wash Waler <br />preparation for this event, <br />preparation and operation. <br />this event. <br />209 464-0138 I www.sjgov.org/ehd <br />TEMP EVENT APP <br />I am providing the <br />booth: <br />□'Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />^fone separate tub (bucket or basin) for the collection of rinse/wastewater. <br />[tfpaper towels and pump-style soap, container. <br />Names of responsible persons to be Resent in booth during all hours of operation^ . <br /> ------ri/-------------- <br /> All food vendor booths are subject to inspection. Please make a copy of sJPP1^0"rj3nf <br />- - ---------‘ A copy of this checklist must be in the booth at all hours of <br />Return original to festival coordinator three weeks prior to <br /> ----------------------- <br />Title <br />-----ll I <br />SANJOAOUIN <br />------COUNTY------ <br />Greatness grows here. <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 />Q4ce chests ^Refrigerator <br /> Refrigerated truck Ice bath and tubs <br /> Other (specify) —----------------- -----------------------------------------------------— <br />I am providing the following items within <br /> Three compartment sink. <br />E'Three deep tubs (basins 6-8 inches minimum), one for soapy water, one for nnsmg and one for a bleach <br />solution (one tablespoon of bleach per gallon of water). <br />[^Detergent, bleach, and wiping cloths (cleaning towels). <br />fTOub to store wiping cloths in bleach solution. <br />following for adequate hand washing facilities, but separate from utensil wash within my