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foods below <br />10 <br />11. <br />OR <br />12. <br /> One separate tub (bucket or basin) for the collection of rinse/wastewater <br /> Paper towels and pump-style soap container. <br />Names of responsible persons to be present in bopth during all hours of operation:13. <br />“Important"* <br />Completed by: 14. <br />Signature <br />Health Permit <br />Paper Hand Towels <br />Soap dispenser <br />Cutting Beard <br />BleachPropane Stove <br />Fire Exllnfluisher <br />Ice Cooler <br />Date <br />—7 <br />Soap and Waler <br />/ <br />Rinso Walor <br />O>4 <br />Title <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 />Slerno w/Chaffing <br />Dish <br />5 Gal Hnrid wash <br />Wusiowotor Conffllno' <br />Garbage <br />Can <br />Sanitizer txickei <br />bleach a water tor <br />storing wiping cloths <br />Booth must be on <br />Concrete, Asphalt. <br />Plywood, or a Tarp <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />/pJ-Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />Extra <br />Walor <br />5-20 Gal <br />Hand wash Water <br />SAN JOAQUIN <br />coun’v <br />I/ Extra i<;o Hogs 4 Foot' Con/airinrs must t>o <br />nlni/Kj n <»ctiB0 •>"ottho groum/l <br />1868 L Hazelton Avenu® | Stockton. California 95205 | T 209 46B-342O | F 209 464-0138 I www sjgov org'ehd <br />•HU 1ft.Q2 pay. sol I* TEMP EVL N I APP <br />'Wt 19/19 <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 aneboperation. Return original to festival coordinator three weeks prior to <br />this event. <br />i Pnjpana TanH <br />I am providing the following cold temperature control for the cold holding of potentially hazardou <br />45°F (if food is used the following day, maintain below 41°F temperature): <br />n Ice chests zS Refrigerator <br />'Q,!Refrigerated truck Ice bath and tubs <br /> Other (specify) ____________________________—--------- - <br />Environmental Health Depart™ <br />lamproviding the following items within my booth for the sanitary cleaning of food preparation utensil <br />[2£fhree compartment sink.