Laserfiche WebLink
Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br />13. <br />Important** <br />14. Completed by: <br />lure <br />Health Permit <br />Papar Hand Towats <br />Cutting Board <br />■A BleachPropane Stove <br />Propana Tank <br />Bleach and WaterRinse Water <br />Ice Cooler <br />TEMP EVENT APP1868 E. Hazelton Avenue | <br />EHD 18-02 <br />07/01/2024 <br />Stemo w/Cbafflng <br />Dish <br />Garbage <br />Can <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />5 Gal Hand wash <br />Wastewater Container <br />5-20 Gal. <br />Hand wash Water <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping doths <br />SAN JOAQUIN <br />COUK-v <br />CXZ' A jL <br />Title <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />EfWater supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />0z6ne separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Q^aper towels and pump-style soap container. <br />Stockton. California 95205 | T 209 468-3420) F 209 464-0138 | www.sjgoy org/ehd <br />Page 8 of 11 TEMP EVENT Al <br />rJ <br />Names of responsible persons to be present in booth during all hours of operation: <br />Extra Ice Bags 4 Food Contain ors must ba <br />stand 6 inches offoltho groundl <br />^rp providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />L/fThree deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br />soMion (one tablespoon of bleach per gallon of water). <br />0uetergent, bleach, and wiping cloths (cleaning towels). <br />Qiub to store wiping cloths in bleach solution. <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 />01ce chests Refrigerator <br /> Refrigerated truck Ice 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 />preparation and operation. Return original to festival coordinator three weeks prior to <br />this event. <br /> <br />J&inafore Title Date <br />Soap dispenser