Laserfiche WebLink
<br />Environmental Health Department <br />10. <br />11. <br />OR <br />but separate from utensil wash within my <br />12. <br />13. <br />“Important** <br />Completed by:14.DateTitleSignature <br />Health Permit <br />Paper Hand Towels <br />Soap dispenser <br />Propane Stove <br />Propane Tank <br />Bleach and WaterRinse WaterSoap and Water <br />Fire Extinguisher <br />TEMP EVENT APP <br />Sterno w/Chaffing <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 fee Bags & Food Containers must be <br />stored 6 inches off of the ground! <br />5-20 Gal. <br />Hand wash Water <br />f=.—/i <br />Ice Cooler <br />.y <br />” 209 468-3420 I F 209 464-0138 | www.sjgov.org/ehd v-rtk. | TCMPPVPNTAI <br />Page 8 of 11 <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 o <br />this event. <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T <br />M rs <br />EHD 16-02 ’ <br />06/19/19 <br />SAN JOAQUIN <br />-—COU N l Y— <br />GTentwss Tsera.. <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 />^flce chests Refrigerator <br /> Refrigerated truck lJ Ice bath and tubs <br /> Other (specify)----- -------------------------- ---------------------------------------- ————— <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 />I am providing the following for adequate hand washing facilities, <br />booth: <br /> Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />EfOne separate tub (bucket or basin) for the collection of rinse/wastewater. <br />H^Paper towels and pump-style soap container. <br />Names of responsible persons to be present in booth during all hours of operation. <br /> <br />San Ae ---------------- ----------- -----------------------— <br />Extra <br />Water <br />Bleach