Laserfiche WebLink
Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br /> Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />13. <br />Return original to festival coordinator three weeks prior to <br />14.Completed by: <br />Title <br />Health Permit <br />Paper Hard Towels <br />Soap dispenser <br />Cutting Board <br />BleachPropane Stove <br />Rinse Water Bleach and WaterSoap and Water <br />F:re Extinguisher <br />Ice Cooler <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> Three compartment sink. <br />Extra Ice Sags X Food Containers must be <br />stored S inches of'of the ground! <br />Sterno w/Chaffir.g <br />Dish <br />5 Gal Hand wash <br />Wastewater Container <br />Garbage <br />Can <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 />Extra <br />Water <br />5-20 Gal <br />Hand wash Water <br />bANjJU'UJUIN <br />------COU Y------ <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 415F temperature): <br />"Snce chests Refrigerator <br />/□ Refrigerated truck Ice bath and tubs <br /> Other (specify)___________ _ ____ __ <br />VYThree 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 />Prepare Tank <br />Date <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 aad operation. <br />this eyefitTY ) <br />Signatu/e <br />‘‘Important* <br /> One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Paper towels and pump-style soap container. <br />Names of responsible persons to be present in booth during all hours of operation. <br />______________________________________ <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | v/ww.sjcehd.com <br />EHD 16-02 Page a of 11 TEMP EVENT APP <br />07/3/17