Laserfiche WebLink
,.i,e:rxr.its..-I.rc.wrx,iu_ „—.:::'vita'M'SI:S![i'1LJiliSlilLS19131'1�1s! .�:qmt�,lure:¢;:IxKkui[di¢urlllnLE:lr1],DS.Ie+luL1�,3.�;Q•'�T.�° t' •r <br /> SAN J OAQU f N l Mvir-ont-neAntal Health Department <br /> C" 0t.JNTY <br /> 10. 1 am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 45OF(if fond is used the following day, maintain bolow 41°f=ternporaturo): <br /> L] Ice chests ❑refrigerator <br /> ❑ Refrigerated truck (] Ice bath and tubs <br /> ❑ Other <br /> 11. I ant providing the following items within my booth for tho sanitary cleaning of food preparation utensil <br /> ❑ Three compartment 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 /> &VGter supply dispenser with warm water at a minimum of 100°F(i.e. 5-20 galion container with spigot), <br /> Q�One separate tub(bucket or basin)for the collection of rinse/wastewater, <br /> :aper towels and Pump-style soap container, <br /> 13. Names of responsible persons to be present in booth during all hours of operation: <br /> **Important** 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 operati n. <br /> th1s event. y — <br /> 14- Completed by: -��•� , <br /> Signature MM— <br /> Title5-20 <br /> Health PermitHand wadwa <br /> SWmo wlChalfmg sh Wales <br /> Dish <br /> Paper Hand Towals <br /> � Sump rflspolunr <br /> Cuss,{Ek'prd I - <br /> J Sue�rrar budCl- <br /> Prr,Vl„K Sulu: ble.Kh d wa[er fnr <br /> 01wIUr skunlgwipinp ckHhs <br /> Booth must be on <br /> l ai' :•i1• Concrete, AsptWl, <br /> Plywood.ora Ta <br /> 1l� � 1p. <br /> _ <br /> lIu.11l IM4l WA4T (( I411. W.IIar IrkulGl Nk(WAX <br /> I ...- Garbage <br /> !au I:.kawlU.tlellw I N CAl1 <br /> 1 ao a <br /> Ice Cooler sro 7- <br /> 1868 <br /> eNi ooitHatPrrlhcCua <br /> V.rurNll�nlryaayl!s <br /> musVt huf. yl <br /> y Wr6wOlu.wrlaflladrrulalwxl.11.rnlr <br /> m <br /> E.Hazelton Avenue[ Stockton, California 95205 j T 209468-34201 F 209464-0138 [ www.sjcehd.com <br /> Elio 16.02 <br /> 07!3117 Papu 6 Gf 11 TEMP EVENT APP <br />