Laserfiche WebLink
Environmental Health Department <br />10. <br />□ Ice bath and tubs <br />11. <br />OR <br />12. <br />13. <br />14.Completed by: <br />Paper Hand Towels <br />Soap dispenser <br />Cutting Board 1Propane Stove Bleach <br />0 <br />Propane Tank <br />Fire Extinguisher <br />0 <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 I F 209 464-0138 I www.siqov.ora/ehd <br />I™1.6;02 Page 8 of 11 TEMP EVENT AlTEMP EVENT APP06/19/19 <br />Soap and Water <br />zz: <br />Rinse Water <br />Sterno w/Chaffmg <br />Dish <br />5 Gal Hand wash <br />Wastewater Container <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping cloths <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />5-20 Gal. <br />Hand wash Water <br />SAN JOAQUIN <br />- COU NTY - <br />Title <br />1. - - <br />Extra Ice Bags & Food Containers must be <br />stored 6 inches off of the ground! <br />Health Permit I <br />**lmportant** <br />I 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 temperature): <br />□ Ice chests 0 Refrigerator <br />□ Refrigerated truck <br />□ Other (specify) <br />I ■------------ - <br />Garbage <br />Can <br />Ice Cooler <br />I am 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 />ZZ0 Detergent, bleach, and wiping cloths (cleaning towels). <br />M Tub to store wiping cloths in bleach solution. <br />Names of responsible persons to be present in booth during all hours of operation: <br /> <br /> <br />' 't** All food vendor booths'are sublet 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 an cooperation. Return original to festival coordinator three weeks prior to <br />this event. // > . 7 ~ ~7 <br />____Y/z-'rZi <br />Signature 1 Title Bate ' <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />Water supply dispenser with warm water at a minimum of 1 GOT (i.e. 5-20 gallon container with spigot). <br />E One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />[_3 Paper towels and pump-style soap container. <br />Extra <br />Water