Laserfiche WebLink
Environmental Health Department <br /> <br />w <br />11 <br />OR <br />12 providing the following for adequate hand washing facilities but separate from utensil wash within my <br />13 <br />••Important” <br />14 Completed by <br />Health Permit I <br />’WiWt <br />tSseacr. <br />s <br />« 'At!*! <br />Ice Cooler 1 <br />I am <br />bootr <br />Garbage <br />Can <br />ie® $ «4xxf M <br />as??>s^ « jrx? <br />*«*?- V»at^ <br />Eat’* <br />■sro?^ ta^ssr^j s&IHa <br />SAN JOAQUIN <br />■■ - COUNTY- <br />± <br />«>»*«» YVW <br />I am^providing the following cold temperature control for the cold holding of potentially hazardous foods below <br />4&'F (if food is used the following day maintain below 41 F temperature) <br />i£f Ice chests Q Refrigerator <br /> Refrigerated truck Q ice bath and tubs <br /> Other (specify) _____ <br />Zj Three deep tubs (basins 6-8 inches minimum) one for soapy water one for rinsing and one for a bleach <br />station (one tablespoon of bleach per gallon of water) <br />0 Detergent bleach and wiping cloths (cleaning towels) <br />O Tub to store wiping cloths in bleach solution <br />! ®Tn providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />LJ Three compartment sink <br />5 Gfe H#r>g «»>*> <br />Cw <br />Tan*. <br />---------------------------i <br />I — <br />Booth must fce on <br />Concrete Asphalt <br />Plywood ot a TerpL <br />/Lj Water supply dispenser with warm water at a minimum of 100 F (i e 5-20 gallon container with spigot) <br />pfone separate tub (bucket or basin) for the collection of rinserwastewater <br />Paper towels and pump-style soap container <br />Names of responsible persons to be present m booth during all hours of operation <br />_______CQ^-^,C »- ____________________ <br />AH 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 m the booth at all hours of <br />preparation and operation Return original to festival coordinator three weeks prior to <br />this event. I f C \ <br />_________________________If j Xe 13 V A-) <br />Signature / Tftle Date <br />186^ S^ton CaMorna95?05i I 20946844201 F 209 464.0138 | www^qvofg/eho <br />^^8 <>• ''TEMP EVEMT APP