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I <br />Environmental Health Department <br />10. <br />11. <br />OR <br />12 <br />B 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 />B Paper towels and pump-style soap container <br />13. <br />‘"Important** <br />14. <br />Signature <br />Health Permit <br />Paper Harp Towels <br />IBleacnPropane Stove <br />0 <br />Propane I ank <br />B-l Bleach and Water <br />FireEitingiitsner <br />Ice Cooler <br />Names of responsible persons to be present in booth during all hours of operation: <br />Frank Teixeira <br />Sterne w/Cliaffitrg <br />Drstr <br />Ertta <br />Water <br />5 Gal iand wasn <br />Wastewtiter container <br />Garbage <br />Can <br />Sonrlrzer bucket <br />bleacn & wate' for <br />storing wiping cloths <br />Booth must be on <br />Concrete. Asphalt <br />Plywood, or a Tarp <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 />B Refrigerated truck Ice bath and tubs <br /> Other (specify) <br />5-20 Gat <br />I land wash Water <br />SAN JOAQUIN <br />C OI ' N T / <br />office coordinator <br />Title <br />___________________ <br />E»lra (co Bags S food Contameis must be <br />stuiud 6 inches olt ol the giound' <br />L <br />Soap and Water Rinse atui <br />Soap c spenser <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 />this event. <br />Completed by: Sondra Berchtold 8-25-25 <br />Date <br />LI 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 />B Three compartment sink <br />1868 t Hazelton Avenue I Stockton, California 95205 | T 209 468-3420) F 209 464-0138 | wwwsigov.org/ehd <br />EHD 16-02 Page 8 of 11 TEMP EVENT APP <br />06/19/19 <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />Cutting Board