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Environmental Health Department <br />w. <br />A <br />11. <br />OR <br />12. <br />Names13. <br />‘‘Important** <br />Completed by:14. <br />Health Permit <br />Paper Hand Towels <br />Soap dispenser nBleach <br />Propane Stove <br />u D <br />Ptopar>e Tank <br />Bleach and Waterz/ <br />fuo Edinpuishor <br />L <br />Starno w/Chaffinfl <br />Dish <br />5 Gal Hand wash <br />Waslewaler Container <br />Garbage <br />Can <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />.__________■ _..................t-.-.s4wa, <br />Er'ra Ice Bags i Food Containers must be <br />sb rod fl Inches off of Hie groondl <br />5-20 Gal <br />Hand wash Water <br />Sanitizer bucket­ <br />bleach i waler for <br />SAN JOAQUIN <br />C< UNTY <br />lapt providing the Allowing items within my booth for the sanitary cleaning of food preparation utensil <br />® Three compartment sink. <br />for rinsing and one for a bleach <br />f Exira \ <br />Water <br />Soap and Water IRinsa Waler <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420) F 209 464 0138 | www.sjgov.org/ehd <br />EHD 16-02 Page 8 of 11 TEMP EVENT app <br />07/01/2024 <br />Ice Cooler <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 pnor_tg <br />h/^/2 s <br />Signature Title Date <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). <br />I am providing the following for adequate hand <br />booth: <br />Cfwater supply d spenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />C One separate Ub (bucket or basin) for the collection of rinse/wastewater. <br />Q^Paper towels and pump-style soap container. <br />of responsble persons to be present in booth during all hours of operation: <br />y>J > L-Vi A Q Q « '^2-. __________________—--------------------------------------- <br />Q Three deep tubs (basins 6-8 inches minimum), one for soapy water, one <br />solution (one tablespoon of bleach per gallon of water). <br />Q Detergent, bleach, and wiping cloths (cleaning towels). <br /> Tub to store wiping cloths in bleach solution. <br />washing facilities, but separate from utensil wash within my