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Environmfentaf Health Department <br />utensilFl Three compartment sink. <br />12. <br /> Paper towels and pump-style soap container. <br />13. <br />Completed by^14. <br />Health Permit I.! <br />Paper Hand Towels <br />Snap dispenser <br />■ <br />Propane Stove Bleach <br />Bleach and Waler <br />Page 3 or 11 TEMP EVENT APP <br />B <br /> Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />C] One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />0 Gal Hand wash <br />Waslewalor Container <br />6-20 Gal. <br />Hand wash Waler <br />Garbage <br />Can <br />SanltlzorbucXat- <br />Ncach 8 water for <br />storing wiping cloths <br />Booth must be on <br /> Concrete, Asphalt, <br />Plywood, ora Tarp. <br />Extra Ice Bags i Food Conlafners musl ba <br />stored 6 Jnches gtf ol the grOumil <br />Slerno w/Chatnng <br />Dish <br />Ice Cooler <br />.yi <br />Rinse Waler <br />Propane Tank <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjcehd.com <br />EHD 16-02 Page 8 of 11 ■ • . tcmpcx/cni <br />07/3/17 • ... ------------------- <br />11. lam providing the following items within my booth for the sanitary cleaning of food preparation <br />U Three compartment sink. <br />OR <br />Culling Board <br />I operation. Return original to festival coordinator three weeks prior to <br />IkOmiL- <5i[5lUp <br />Signature Title Date <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 />Ll Tub to store wiping cloths in bleach solution. <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 <br />Khls event. <br />Names of responsible persons to be present in booth during all hours of operation- <br />WcAA&fA | ‘ <br />L-l£> K _________________ <br />“important** , <br />Fire Extinguisher I <br />Os SANJOAOUIN <br />—COUNTY— <br />Cfearocss c/rcm-s here. <br />1 °' ' ‘he foj7in? fOld teniPera,ure “ntrol for the cold holding of potentially hazardous foods below <br />4^ 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 />jXother (specify) ft <br />MM <br />Soap and Waler <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within mv <br />booth: