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w <br />11. <br />OR <br />12. <br />Q Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot) <br />□ One separate tub (bucket or basin) for the collection of rinse/wastewater <br />□ Paper towels and pump-style soap container. <br />13 <br />'•Important** <br />14.Completed by <br />Title Date <br />Health Permit <br />Papa* Hand Toass <br />Soap dispenser <br />Culbns Board <br />I.BleachPropane Slova <br />T <br />Propane Tank <br />Bleach and Water <br />Piro Exlnguishor <br />Ice Cooler <br />E'lra ice Sags £ Focd Containers must oe <br />stored 6 inches ett ot the ground' <br />Slerno w/Chafl ng <br />Ouh <br />Exira <br />Water <br />5 Gal Hand v> ash <br />Wasieardter Conla nor <br />Garbage <br />Can <br />Sanzier tuewn- <br />b-'eacn & .ts1 for <br />sexx-g » c>ng e'etns <br />Booth must be on <br />Concrete. Asphalt. <br />Plywood, or a Tarp <br />Names of responsible persons to be present in booth during all hours of operation: <br />Jennifer and Derek Deo <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 />.this's venfTx <br />1368 E Hazelton Avenue | Stockton California 95205 | T 209 468-34201 F 209 464-0138 I www sjgov org'end <br />EHD 16 02 Page 6 Of 11 TEMP EVENT APR <br />06/19/19 <br />IT U <br />Rinse V/atar <br />Olx <br />5^0 Gal <br />Hand wash Water <br />lam 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 nnsing and one for a bleach <br />solution (one tablespoon of bleach per gallon of water). <br />□ Detergent, bleach, and wiping cloths (cleaning towels). <br />LZ] Tub to store wiping cloths in bleach solution. <br />l^am^providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />Scap and Water <br />' a^o?r°yiain9 lne ro"owmg coia temperature comroi ror me coia noiamg or potentially nazaroous iooos oe.ow <br />45 F (if food Is used the following day, maintain below 41°F temperature) <br />□ ice chests 0 Refrigerator <br />□ Refrigerated truck 0 ice bath and tubs <br />□ Other (specify)