Laserfiche WebLink
Environmental Health Department <br />10. <br />11. <br />OR <br />washing facilities, but separate from utensil wash within my <br />12. <br />13. <br />•‘Important” <br />Completed14.Signature^ <br />Health Permit <br />Paper Hand Tomh* <br />Soap <br />CsXtinj 8o*'d <br />BioacP <br />Propane stove <br />it1 <br />Bleach and WaterR.r»c Water <br />]I «e ( .prqulhor <br />I EMP EVENT APP <br />1 <br />S'.orno wi-Oa^ng <br />5 Gal nano waih <br />Waalcwater Container <br />Booth must be on <br />Concrete, Asphalt. <br />Plywood, or a Tarp <br />Garbage <br />Can <br />Sanczor bvcKet <br />Coach 4 water tor <br />itonng wiping cWH <br />S20 Gal <br />Hard wain Wa’xr <br />SAN JOAQUIN <br />-------COUNTY------- <br />a <br />Ice Cooler <br />Ol^Ae/' <br />Title <br />I <br />Soap and Water <br />1868 E. Hazelton Avenue | Stockton, <br />EHD 16-02 <br />OMft-19 <br />I am providing the following for adequate hand <br />booth: <br />Propa-e 7»-x _________> <br />I am providing the following cold temperature control for the cold holding of potent.ally hazardous foods below <br />45’F (if food is used the following day. maintain below 41 F temperature). <br />(^Ice chests ^-Refrigerator <br />[j Refrigerated truck O Ice bath and tubs <br />□ Other (specify) -------------------------------------------------------------------------- -—————• <br />Paper towels and pump-style soap container. <br />Namesjf responsible persons toj^r^se^in booth during all hours of operation: <br />All food vendor booths are subject to inspection. Please make a copy of this appli^fon in <br />nrpnaration 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 pnoMo <br />\his events / <br />Date <br />Water supply dispenser with warm water at a minimum of 100T (i.e. 5-20 gallon conta.ner with spigot). <br />One separate tub (bucket or basin) for the collection of nnse/wastewater. <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 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 />E«tr» &»gi 4 Food Contact fruit be <br />Itoraj fl rv/Wl off Of IM fyXXZKJ' <br />California 95205 | T 209 468-3420 | F 209 464-0138 | www.sj^hd <br />Page 8 o< 11