Laserfiche WebLink
SKJiOAQUIN Environmental Health Department <br /> CONTY <br /> �� t�7elIr1C33 t�rrnt hrrrr <br /> 10 1 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 tempe(ature} <br /> %!ce chests ❑Refrigerator <br /> Refrigerated truck ❑Ice bath and tubs <br /> ®Other(specify) 0 Q n su laded <br /> 11 1 am providing the following items within my booth for the sanitary cleaning of food preparation uten0 <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 stare 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 /> Water supply dispenser wsth warm water at a minimum of 100"F(i a 5-20 gallon container with spigot) <br /> me separate tub(bucket or basin)for the collection of nnsetwastewater <br /> KI-Paper towels and pum2-slyle soap container <br /> 13 Cames of irqspon ible perqons.to be present in booth during all hours of operation <br /> "fmportanr' 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 oper lion Retum original to festival coordinator three weeks prior to <br /> tMs eue t -- ,ry� <br /> t4. Completed by W�e !►/Q (�� 1 2-6 <br /> in ure Title Date <br /> SSO GW <br /> H�no wash Wale <br /> Health Permit s r fcw-j <br /> Oyh Papas H"Tv I% <br /> Soap msprye+ <br /> CJtl�a,wa CleKh 8 walr ra <br /> asasSp wpk+p dotty <br /> P'Vp"slo. �trarh <br /> Booth must be an <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp <br /> Saco anq werw R"M tn'm+. awr W&W Garbage <br /> Can <br /> fv��s111pnaryr <br /> Wat« <br /> Ficeooler_. _ �raeJ i urrner ON MMe Oro qe <br /> 1866 E. Hazelton Avenue I Stockton, California 052051 T 200 468-3420 1 F 209 464-0138 1 www sj9 v.rgIehd <br /> CHo io,02 f ago d of+t TEMP <br /> 6Ar1 of S 9 <br />