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Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br />'De separate tub (bucket or basin) for the collection of rinse/wastewater. <br />B-Paper towels and pump-style soap container. <br />13. <br />“Important** <br />Completed by:14. <br />Sign. <br />Health Permit <br />Paper Hand Towels <br />Cutting Board <br />", <br />[BleachPropane Stove <br />L <br />Propane Tans <br />Bleach and Waler <br />Fire Extinguisher <br />' Ice Cooler V <br />§ <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />Boater supply dispenser with warm water ata minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />Extra tee Sags S Food Can tamers must be <br />stored 6 inches oft a! the ground! <br />Exira <br />Water <br />5 Gal Hand wash <br />Wastewater Container <br />Booth must bo on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <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 />Stamp w/Cnatting <br />Dish <br />Sanitizer bucket­ <br />bleach & water tor <br />storing wiping cloths <br />5-20 Gal. <br />Hand wash Water <br />Title <br />SAN JOAQUIN <br />C O U N T Y <br />J <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^ey^it. <br />Soap and Water Rinse Water <br />ab <br />Date <br />I arnpjoviding the following items within my booth for the sanitary cleaning of food preparation utensil <br />[kKfhree compartment sink. <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 /> Ice chests Refrigerator <br />B'^efrigerated truck O Ice bath and tubs <br /> Other (specify) ____ <br />1868 E. Hazelton Avenue | Stockton California 95205 | T 209 468-3420) F 209 464-0138 | www.sjcehd.com <br />EHD 16-02 Page 8 of 11 TEMP EVENT APP <br />07/3/17 <br />Soap dispenser I <br />Garbage <br />Can <br />Names of responsible persons to be present in booth during all hours of operation: