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Environmental Health Department/ >°. <br />10. <br />11. <br />OR for rinsing and one for a bleach <br /> Thn <br />12. <br />5-20 gallon container with spigot) <br />13. <br />Completed by: 14.Title^nature <br />Health Permit <br />Soap disDenser <br />Cutting Board <br />Bleach <br />Propane Slove <br />Propane Tank <br />Bleach and WaterRinse WaterSoap and Water <br />Fire Extinguisher <br />1868 E. Hazelton Avenue | Stockton, <br />ffis e: <br />ope/c <br />I am providing the following for adequate <br />booth: <br />Extra ice Bags & Food Containers must de <br />stored 6 inches off of the ground1 <br />Stemo w/Chaffing <br />Dish <br />Extra <br />Water <br />Garbage <br />Can <br />5 Gal Hand wash <br />Wastewater Container <br />5-20 Gal <br />Hand wash Water <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping cloths <br />Q Water supply dispenser with warm water at a minimum of 100 F (i.e. <br />basin) for the collection of nnse/wastewater <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> Three compartment sink. <br />California 95205 | T 209 468-3420 | F <br />Pans 8 of 11 <br />Paper Hand Towels I <br /> One separate tub (bucket or <br />All food vendor booths are subject to inspection <br />preparation <br />preparation <br />this event> <br />Ice Cooler 0 ’ <br />209 464-0138 | www.sjgov.org/ehd <br />TEMP EVENT APP <br />0 ...^e deep tubs (basins 6-8 inches minimum), one for soapy water, one <br />soluW (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 />hand washing facilities, but separate from utensil wash within my <br />“Important** <br />Booth must be on <br /> Concrete. Asphalt, <br /> Plywood, or a Tarp. <br />___________/ <br />SAN,JOAQUIN <br />-----COUNTY------ <br />G r 0 O t n ? $ $ q ■ ’ 5 ' f <br />pviding the following cold temperature control for the cold holding of potentially hazardous foods below <br />(if food is used the following day, maintain below 41 °F temperature): <br /> Refrigerator <br /> Ice bath and tubs <br />;? 'o?_ <br /><' ! : 7. <br />J site*: <br />I am pre <br />45>F< <br />Hdce chests <br /> Refrigerated truck <br /> Other (specify) <br />[^]p£per towels and pump-style soap container. <br />Name^r^pongto^presem in booth dun^ aB h^pergon: <br /> <br />) i113pcw;v.i. Please make a copy of this application in <br />A copy of this checklist must be in the booth at all hours of <br />"Upturn original to festwal coordinator three weeks prior to <br /> zDa(e/ '