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Environmental Health Department <br />11. <br />ft OR <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.Names of responsible freons to be present in booth duringyoursoperation: , <br />14. Completed by: <br />Signature <br />Health Permit <br />Paper Hand Towels <br />Soap dispenser <br />Cutting Board 1 IBleachPropane Stove <br />0n <br />Propane Tank <br />Piro Extinguisher <br />Ice Cooler <br />TEMP EVENT APPPage 8 of 11 <br />Extra <br />Water <br />Garbage <br />Can <br />Stemo w/Chafling <br />Dish <br />5 Oat Hand wash <br />Wcstcwotcr Contains! <br />Sanitizer bucket- <br />bloach & water for <br />storing wiping dolhs <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, ora Tarp. <br />12. <br />SAN JOAQUIN <br />COUN’v <br />(ration. Return original to festival coordinator three <br />Title <br />"Important** <br />z <br />Soap and Water <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 an^ o^eration. Return original to festival coordinator three weeks prior to <br />this event. / — ' A <br />Date <br />lu_Z <br />Rinse Water <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 for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />lam providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> Three compartment sink. <br />’ the fo,,owin9 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 />Extra Ice B«g« & Food Containan mu*f bo <br />elorod 6 Inches oft of the ground! <br />1868 E. Hazelton Avenue | Stockton. California 95205 | T 209 468-3420 | F 209 464-0130 | wmv.sjgovxngfehd <br />EHD 16-02 Page 8 of 11 <br />07/01/2024 <br />fl 10- <br />5-20 Gal. <br />Hand Water