Laserfiche WebLink
Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br />13. <br />“Important** <br />14. Completed by: <br />Health Permit <br />:•; :i- ■■ <br />Ptptr H»M Towcli <br />Sojp Mptawf <br />r-rt.riA» <br />Prurvn <br />Fuo Eeawuubei <br />Ice Cooler | <br />Hazelion Avenue | Stockton, California 95205 | T 209 468-3420 I F 209 464-0138 I <br />P«0® 8 ol 11 <br />C»fr» lc« B*j» 4 frod Canttm^n mjtl b» <br />6 Intht) tJ! d IT* erovnxfl <br />Garbage <br />Can <br />1868 E. <br />EHD 18-02 <br />00/18/19 <br />St.rrWHXM'fr.a ► _ <br />□us ; <br />Booth must bo on <br />Conc/olo, Asphalt. <br />Plywood, ora Tarp <br />t 0*1 H»na wakh <br />SAN JOAQUIN <br />COU! I I Y <br />W«t«< <br />■.; , c-1. . <br />I am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br />45T (if food Is used the following day, maintain below 4 TF temperature): <br /> Ico chests WRefrigeralor <br /> Refrigerated truck Ice bath and tubs <br /> Other (specify)______________________________________________________________ <br />FT L~_z <br />Bmp bm w«to/ <br />5 <br />Rzm W*t«r <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 al all hours of <br />preparation anef Aperation. /Return original to festival coordinator three weeks prior to <br />\j^( - Signature.K r- <Yitlo -sh . - Dhte/- <br />SxxMm 6vck»|. <br />, S. V.*!., tc <br />/ MM'njw'pir'CCto'h* <br />Jr <br />1 8-20 G»I <br />H*n4wa»hW*i« <br />-y <br />www.sjgov org/ehd <br />TEMP EVENT APR <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <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 />^Jgfwater supply dispenser with warm water at a minimum of 100'F (l.e. 5-20 gallon container with spigot). <br /> One separate tub (bucket or basin) for the collection of rlnse/wastewater. <br />pEjPaper towels and pump-style soap container. <br />Names of responsible persons Io be present in booth during all hours of operation: <br />[Cca !/'<<< / Jt _ <br />lam providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />Kjhree compartment sink.