Laserfiche WebLink
Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br />13. <br />••Important** <br />Completed by: 14.Signature <br />Health Permit <br />P*p«rK*rxJTmwb <br />D:MChtndWil« <br />. 7 <br />rt*Q <br />TEUP EVENT AFPPago 8 o< 11 <br />J.I <br />Santoar DuO<«- <br />UMcnlwawIcr <br />tiomg daP» <br />tilamo wChalfog <br />D>»P <br />Extra <br />» G«l Hartl mm* <br />WatlMiar Contamw <br />Gaibage <br />Can <br />Booth must be on <br />Concrete. Asphalt. <br />Plywood, or a Tarp. <br />i <br />I Baach <br />pee Cooler <br />I <br />Soap and W*l«r <br />i <br />5 <br />RlniaWMar <br />Qyvater supply dispenser with warm water at a minimum of 100’F (i.e. 5-20 gallon container pig <br /> One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />S-2O Gat <br />y- HandwMhWatar <br />| Soapaioarw | --------.\ <br />bM k* I roal ConiUnut mvU t>» Il <br />tUndUnOmc/to/ttMOWil IJ <br />Q Paper towels and pump-style soap container. <br />Names of responsible persons to be presenHn booth dmnga^hours <br />All food vendor booths are subject to inspection J’lease make a cc^y <br />this <br />Title <br />186fiE Hazelton Avenue | Stockton. California 952051 T 209 468-3420 | F 209 464-0138 | www.sjcehd.com <br />Page 8 o< 11 T£!»» EVEMT <br />D//1/17 <br />SAN JOAQUIN <br />• - COUNTY----- <br />I em providing the following cold temperaturetcon^^ potentially hazardous <br />45T (if food Is used the following day. maintain below 41 F temperatur ) <br /> ice chests □Refrigerator <br />[^efrigorated tmek Ice bath and tubs <br /> Other (specify)_—--------------------------------------------------------- " <br />I amprovidlng the following items within my booth for the sanitary cleaning of food prepa a <br />□■Three compartment sink. <br />□ Throe deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and <br />solution (one tablespoon of bleach per gallon of waler). <br /> Detergent, bleach, and wiping cloths (cleaning towels). <br /> Tub to store wiping cloths In bleach solution. <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash wi . y <br />booth: