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REC-008 <br />Environmental Health Department <br />hererows <br />10. <br />11. <br />OR <br />12. <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 />13. <br />this event. <br />14.Completed by: <br />Title <br />Health Permit <br />Paper Hand Towels <br />Propane Stove <br />it L <br />Ere Extinguishera <br />IIce Cooler <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 items within my booth for the sanitary cleaning of food preparation utensil <br /> Three compartment sink. <br />5 Gal Harxl wash <br />Wastewater Container <br />Garbage <br />Can <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />Sanitizer bucket­ <br />bleach & water for <br />slonng wprng dcths <br />Booth must be on <br />Concrete. Asphalt. <br />Plywood, or a Tarp. <br />Sier no w ChaHInfl <br />Dish <br />SAN JOAQUIN <br />------COUNTY------- <br />Grc <br />08-26-2025 <br />Date <br />Names of responsible persons to be present in booth during all hours of operation: <br />Syeda Uzma Nadeem_________________________________________________ <br />Abbas Madad <br />“Important** <br />_z <br />Soap and Walor <br />I Bloach <br />I Propane Tank <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 to <br />Signature <br />&ra fce Bags, & rood Coniaswrs must be 1'1 <br />stored 6 mcnes ol ol the ground1 | <br />I Culling Board <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 /> Ice chests Refrigerator <br /> Refrigerated truck Ice bath and tubs <br /> Other (specify) n0lie <br />"Z <br />Rlino Waler <br />1868 E. Hazelton Avenue | Stockton. California 95205 | T 209 468-3420 1 F 209 464-0138 | www.sjgov.org/ehd <br />EHD 16-02 Paso 8 ot 11 TEMP EVENT APP <br />06-19/19 <br />5-20 Gal. <br />r- Hand wash Waler <br />I Soap dispenser I ------------ \ <br />| Bleach and Waler <br />Extra <br />Wafer