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Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br />fater supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />13. <br />‘‘Important** <br />Completed by: 14. <br />DateSigi <br />1 Paper Kind Towels <br />Soap dispenser <br />Cutting Board <br />BleachPropane Stove <br />0T <br />Propane T ank <br />Bleach and Water <br />Fee Extinguisher <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <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 />F Refrigerated truck Ice bath and tubs <br /> Other (specify)___ <br />Extra <br />Water <br />5 Gal Hand wash <br />Wastewater Container <br />Garbage <br />Can <br />©One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Q-Paper towels and pump-style soap container. <br />Stemo w/Chaftmg <br />Dish <br />Sanitizer bucket­ <br />bleach & water tor <br />stonng wiping cloths <br />Booth must be on <br />Concrete. Asphalt. <br />Plywood, or a Tarp. <br />SAN JOAQUIN <br />( ■: >1. i.". i y <br />l^lce Cooler <br />Title <br />Health Permit <br />/ <br />Rinse Water <br />1868 b. 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 />06/19/19 <br />5-20 Gal <br />I land wash Waler <br />Names of responsible persons to be present In booth during all hours of operation: <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />hree compartment sink. <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 />O 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 and operation. Return original to festival coordinator three weeks prior to <br />_± <br />Soap and Water <br />Extra Ice Beg» « FoM Contamen must be \ <br />stored 6 rnchos off of tho groundl