Laserfiche WebLink
SAN JOAQUIN Environmental Health Department <br />10. <br />□ Ice bath and tubs <br />11. <br />OR <br />12. <br />y] Water supply dispenser with warm water at a minimum of 100°F (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 />14.Completed by: <br />Title <br />Health Permit <br />Paper Hand Towels <br />Soap dispenser <br />1 BleachPropane Siove <br />Soap and Waler Bleach and Water <br />Fire Extinguisher <br />Ice Cooler <br />I->S-06/19/19 <br />.___ _ <br />0 kJ k I— <br />/ <br />Rinse Water <br />______ <br />Extra Ice Bags & Food Containers must be <br />stored 6 inches off of the ground! <br />Sterno w/Chaffing <br />Dish <br />Extra <br />Water <br />5-20 Gal. <br />Hand wash Water <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />5 Gal Hand wash <br />Wastewater Container <br />Garbage <br />Can <br />Sanitizer bucket­ <br />bleach & waler for <br />storing wiping cloths <br />Propane Tank ------------- <br />**lmportant**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 />____________ . : , ' 'A. / <br />Signature_____________________Title Date <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 />O Ice chests Q] Refrigerator <br />□ Refrigerated truck <br />[3 Other (specify) <br />-f'fZ: (i*'’' <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />Names of responsiblejcersons to be present in booth during all hours of operation: <br />■ 1868 t. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420] F 209 464-0138 | www.sjgov.org/ehd <br />EHD 16-02 Page 8 of 11 TEMP EVENT APP <br />06/19/19 <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />0 Three compartment sink. Ghvi y. k L | COW 1 (ht <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 />Cutting Board