Laserfiche WebLink
Environmental Health Department <br />11. <br />OR <br />12. <br />13. <br />Completed by:14. <br />Health Permit Paper Hand Towels <br />Cuttinq Board <br />Propane Stove <br />Ice Cooler <br />Soap dispenser <br />Bleach <br />Soap and Water <br />Fire Extinguisher <br />Garbage <br />Can <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping cloths <br />5 Gal Hand wash <br />Wastewater Container <br />c <br />Propane Tank <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />^5® <br />209 464-0138 | www.sjcehd.com <br />TEMP EVENT APP <br />Extra Ice Bags & Food Containers must be <br />stored 6 inches off of the ground' <br />1868 E Hazelton Avenue | Stockton. California 95205^1 TM9 468-3420 | F <br />x ' Stem© w/Chaffing <br />' D'sn <br /> Three compartment sink. <br /> Three deep tubs (basins 6-8 inches minimum), one <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 />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />Boater supply dispenser with warm water at a minimum of 100T (i.e. 5-20 gallon container with spigot). <br /> X separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Q'Paper towels and pump-style soap container. <br />Names of responsible persons to be present in booth during all hours of operation: <br />--- --------------------------------------------------------------------------------- ; <br />“Important** <br />SANiJOAQUIN <br />------COUNTY-— <br />, „ USZK —- - - »«;« —* “ "•45°F (if food is used the following day, maintain below 41 F temperature). <br />Q4e chests Refrigerator <br /> Refrigerated truck EHce bath and tubs <br /> Other (specify)--------------------------------------------------------------- <br />^S^^onlndXton. ^pnginaLto^ <br />this event <br />Title Date <br />5-20 Gal <br />Hand wash Water | <br />for soapy water, one for rinsing and one for a bleach <br />fj/fx