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( <br />1 Ice Cooler <br />.Ehrd a Fo'dd 1',S; <br />stored 6 inches off of the ground! <br />Rinse Water Soap and Water Bleach and Water 1 Garbage <br />Can <br />Paper Hand Towels <br />Soap dispenser <br />Sanitizer bucket- <br />bleach & water for <br />storing wiping cloths <br />I Booth must be on <br />LJLZ,JLI [ Plywood, or a Tarp <br />Concrete Asphalt <br />J <br />1 <br /> <br />Li r <br />hi <br />5 Gal Hand wash <br />Wastewater Container L. <br />Propane Tank <br />! Health Permit ! <br />1 <br />Sterna w/Chatting <br />Dish 11 <br />-1 Cutting Board 1 <br />1 —77714 <br />I <br />I Fire txtinguisner <br />Extra <br />Water <br />7;71, <br />5-20 Gal <br />Hand wash Water <br />SACOAQUIN <br />r"-r-o trs.r—v <br />Environmental Health Department <br />! nm prnviriing the follnyving ternperntt ire r'^nti^l fnr th 0 r'nfri h^!Hing nf pnt3ntinHy hn7nrrir",c frIrvIc htZinVtl <br />45° (if food is used the following day, maintain below 41°F temperature): <br />Ice chests Refrigerator <br />E Refrigerated truck El Ice bath and tubs <br />7 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 />OR <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 />7 Tub VI ctnrrm wiping cloths in bleach snli!tibn. <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />L Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />El One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />.71:rPaper towels and pump-style soap container. <br />Names of respqrysiPle pers ns to be present in booth during all hours of operation: <br />(-1( tvi ft ii Ø i' <br />**Important** <br />Completed by: <br />All food vendor booths are subject to inspection. Please make a copy of this application in <br />preparation fo vent. A copy of this checklist must be in the booth at all hours of <br />preparatio ation. Return original to festival coordinator three weeks prior to <br />nis eve t. <br />erktfkbel2 <br /> <br />Signature Title Date <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 <br />06/29/2023 <br />TEMP EVENT APP