Laserfiche WebLink
Health Permit <br />Sterno w/Chaffing <br />Dish <br />! Fire Extinguisher <br />5-20 Gal <br />Hand wash Water <br />Garbage <br />Can <br />/ <br />F <br />t_ 41.0 IVP.9,141.1.1/0.1.,11.1.1,,,,011/.6.014,...a[P•3•1.10 <br />Extra Ice Bags & Food Containers must be <br />stored 6 inches off of the ground! <br />Ice Cooler 5 Gal Hand wash <br />Wastewater Container <br />Paper Hand Towels <br />Sanitizer bucket <br />bleach& water for <br />storing wiping cloths <br />Soap dispenser <br />Cutting Board <br />Propane Stove <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp <br />SAN)JOAQUIN Environmental Health Department <br />I am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br />45° (if food is used the following day, maintain below 41°F temperature): <br />Ice chests ['Refrigerator <br />E Refrigerated truck E 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 />hree 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). E Detergent, bleach, and wiping cloths (cleaning towels). <br />E Tub to store wiping cloths in bleach solution. <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />0 Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />0 One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Paper towels and pump-style soap container. <br />Names of responsible persons to be present in booth during all hours of operation: <br />kla-a" VD I 1-cr <br />**Important** All food vendor booths are subject to inspection. Please make a copy of this application in <br />prepar ion for this event. A copy of this checklist must be in the booth at all hours of <br />prepar and .p ;'ion. Return oridinal to festival coordinator three weeks prior to <br />this <br />Completed by: <br />Signature <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sjgov.org/ehd <br />EHD 16-02 Page 8 of 11 TEMP EVENT APP <br />06/29/2023 <br />OR <br />07414,11) <br />Title <br />/4/73 <br />Date