Laserfiche WebLink
Environmental Health Department <br />11. <br />OR <br />12. <br />13. <br />14.Completed by:Owner 09/22/2022 <br />Signature Title Date <br />Health Permit <br />Paper Hand Towels <br />Cutting Board <br />Propane Stove Bleach <br />f <br />Propane Tank <br />Bleach and W^er <br />1 <br />Ice Cooler <br />Refrigerator <br />Ice bath and tubs <br />Garbage <br />Can <br />5 Gai Hand wash <br />Vwhstewate* Container <br />5-20 Gal <br />Hand wash Water <br />,205 | U-<-» <br />Page 8 of 15 <br />Fi <br />1868 E. Hazelton Ail ' <br />EHD 16-02 i— <br />Ice chests <br />Refrigerated truck <br />Other (specify) <br />Rinse Water- <br />Fire Extinguisher <br />Soap and Water <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping cloths <br />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 />“Important** <br />preparation for this event, f ‘ \ <br />preparation and operation. Return original to <br />this event- <br />______Harjinder Singh_______________ <br />| F 209 464-0138 ' www sjgov org/ehd <br />TEMP EVENT APP <br />Pr0v'<^in9 fhe following items within my booth for the sanitary cleaning of food preparation utensil <br />Stemo w/Chaffmg <br />Dish <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 />SAN JOAQUIN <br />------COUNTY <br />Creatness grows here. <br />Names of responsible persons to be present in booth during all hours of operation- <br />Harjinder Singh, Arun Kaushik, Sandeep Singh, Harpreet Kaur <br />All food vendor booths are subject to inspection. Please make a copy of this application in <br />~ F°py of. tJ’is .checWist must be in the booth at all hours of <br />ival coordinator three weeks prior to <br />Extra tee Bogs & Food Containers must be I <br />stored 6 inches off of the ground' - <br />• $ 'T1 t- - <br />l^providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp