Laserfiche WebLink
Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br />(Xwater supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />O One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />HU Paper towels and pump-style soap container. <br />13. <br />"Important” <br />Completed by: 14. <br />Title DateSignature <br />Health Permit <br />1 Paper Hand Towsto <br />Cutt»XJ Board <br />Propane Stove <br />K <br />Propane Tank. <br />Fire Exlngunbe.' <br />Ice Cooler <br />5-20 Gal <br />Hand wajh Water <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />0 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 />0 Detergent, bleach, and wiping cloths (cleaning towels). <br />0 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 />this event. <br />5 Gal Hand wash <br />Wastewafer Container <br />Garbage <br />Can <br />Booth must be on <br />Concrete. Asphalt, <br />Plywood, or a Tarp. <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />Stemo wOaffrg <br />Dnb <br />Sanitizer budcet- <br />Dteach 1 water for <br />storing wiping doths <br />SAN JOAQUIN <br />COUNTY <br />C'eamen ■■ <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 />0 Ice chests 0 Refrigerator <br />0 Refrigerated truck 0 Ice bath and tubs <br />0 Other (specify). <br />, - - 7 <br />Soap and Water <br />I Soap dspenser <br />Extra Ice Sags & Food Ccniamera mint be H <br />stored 6 inches off o/the ground' | <br />Beacn <br />1868 E. Hazelton Avenue I Stockton, California 95205 | T 209 468-3420] F 209 464-0138 | www.sjcehd.com <br />EHD 16-02 Page 8 of 11 TEMP EVENT APP <br />07/3/17 <br />x <br />X Rinse Wll«r Bleech end Weter <br />0 <br />Names of responsible persons to be presentin booth during all hours of operation: <br />*d_ ft. <7X0, ______________