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"S <br />Environmental Health Department <br />10. <br />11. <br />OR <br />12.washing facilities, but separate from utensil wash within my <br />13. <br />14. <br />Paper Hand Towels <br />Soap dispenser <br />Propane Slove Bleach <br />JPropane Tank <br />Rinse Water <br />Fire Extinquisher <br />Sterno w/Chafllng <br />Dish <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping cloths <br />Booth must be on <br />Concrete. Asphalt, <br />Plywood, or a Tarp <br />minimum of 100°F (i.e. 5-20 gallon container with spigot), <br />collection of rinse/wastewater. <br />T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />° TEMP EVENT APP <br />Garbage <br />Can <br />1868 E. <br />EHD 16-02 <br />07/01/2024 <br />S Gal Hand wash <br />Wastewater Container <br />5-20 Gal. <br />Hand wash Water <br />E’Xfrfl ICG R FfVtH rnnlninni^ ' <br />$ <br />SAN JOAQUIN <br />COU NTY- <br />| Ice Cooler <br />( Extra <br />Water <br />Water supply dispenser with warm water at a <br />One separate tub (bucket or basin) for the <br /> (p Paper towels and pump-style soap container. <br />Names of res^^bl^ during 3,1 hours of 0Perati°n; <br />___i <br />Soap and Water <br />**lm portant** <br />Hazelton Avenue | Stockton, California 95205 |------ <br />Page 8 of 11 <br />Health Permit <br />Extra Ice Bags & Food Containers must be <br />stored 6 inches off of the ground! <br />□ ThreecXartXTjPnk temS my b°Oth ,Or 'he Sani‘ary Cleanin9 °f f°Od PreParation utensl1 <br />f°r S°aPy °"e f°r ri"Sl"9 and one a “-h <br />’0 Detergent, bleach, and wiping cloths (cleaning towels). <br />Tub to store wiping cloths in bleach solution. <br />I^am providing the following for adequate hand <br />a <br />Bleach and Water <br />' ^TOHood ithuJprt^nf9l?°,d te™perature for the cold ^'ding of potentially hazardous foods below <br />45 F (If food is used the following day, maintain below 41 °F temperature): <br />'SRjce chests Refrigerator <br /> Refrigerated truck pgjjce bath and tubs <br /> Other (specify)____________________ <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 /> th^P!vJntn and °peratlon £gturn original to festival coordinator three weeks prior to <br />knis eveni,Completed by: l/C^ Q <br />Signature Tjt|e Jate' <br />Cutting Board