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Environmental Health Department <br />10. <br />N/A <br />11. <br />OR <br />12. <br /> Water supply dispenser with warm water at a minimum of 100T (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 />/LCompleted by:14. <br />nature <br />Health Permit <br />P«m> Hmd TowM <br />Soap daoanur <br />Propara Slova <br />Propane Tan* <br />e Fra Exangunhar <br />Ice Cooler <br />Scanned with CamScanner <br />Sarrtuw buc*a<- <br />Maacn & water for <br />ekmng aro*^) ctom» <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 /> Detergent, bleach, and wiping cloths (cleaning towels). <br /> Tub to store wiping cloths in bleach solution. <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 />5 Gal Hand wash <br />Wasbrwalar Contwnm <br />S-20 Gal <br />Hand wash «Va>ef <br />Stamo wChaffing <br />D«h <br />Garbage <br />Can <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />Names of responsible persons to be present in booth during all hours of operation: <br />Aileen and Paul Nguyen <br />Booth must be on <br />Concrete. Asphalt. <br />Plywood, or a Tarp. <br />Owner <br />Title <br />J. <br />Soag and Watar Rmsw Wawr Bleach and Wafer <br />Crtra tee Bags t Food Contar^ers musl bo B <br />stored fl ncbes off a! the gmund1 JH <br />1868 E. Hazelton Avenue | Stockton. California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjcehd.com <br />EHD 16-02 Page 8 o< 11 TE MP EVENT APP <br />07/3/17 <br />June 4, 2019 <br />’ • Date <br />Cifftng Board <br />SAN JOAQUIN <br />COUNTY <br />Greotness grows here <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 Refrigerator <br />Q Refrigerated truck Q Ice bath and tubs <br /> Other (specify).