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Environmental Health Department <br />11. <br />OR <br />12 <br />13. <br />"important** <br />Completed by;14 <br />Signaturer <br />Health Permit <br />Paper HandTcMeb <br />Pron.v.e Stove <br />Propa/wTank <br />Soap Water <br />]Fire ErtnguniOer <br />• - k«• ~ r» <br />Ft <4 <br />KSuira <br />From: <br />Subject: <br />Date: <br />To: <br />Speer BBQ info@speerbbq.com <br />Forms <br />May 20. 2023 at 9:45 AM <br />GaryGreider gary@greider.us <br />Stomo udCMirtog <br />5-20 Gal <br />Hand *»li Water <br />Booth must be or <br />Concrete. Asphalt <br />Plywood, or a Tag <br />3 o«: H*na wosh <br />Wntewjter Contamer <br />Garbage <br />Can <br />Sanitate bncknt- <br />bferxh & ■On lor <br />ttonnp 'A<p<ng clotht <br />SAN JOAQUIN <br />-COUNTY <br />Rmoe Water 1 <br />J IIce Cooler U <br />1 arn Prov'tlin9 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 />□ Refrigerated truck ice bath and tubs <br />□ Other (specify)____________________ <br />I a3«^8^afiMdCa-te«cr9PMift><. H <br />I ^anaiindvaotfcfltKgeajnai <br />Jam providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />Three compartment sink. <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 />\ <br />etoactiandWW I <br />booth pf0V’din® ,he fo,,ow'n9 for adequate hand washing faalities. but separate from utensil wash within my <br />Water supply dispenser with wane water at a minimum of lOOT (i.e. 5-20 gallon container with spigot). <br />L^pne 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 booth during all hours of operation- <br />UschcU.i iW _____________________ <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 />_______ <br />Title Date <br />Cuttlna Roetd <br />Extra <br />Water. <br />to