Laserfiche WebLink
Envhwimentall I! Health Department <br />10. <br />K < / /i <br />11. <br />OR <br />12. <br /> One separate tub (bucket or basin) for the collection of rinse/wastewater. <br /> Paper towels and pump-style soap container. <br />13. <br />14.Completed by: <br />Signature <br />Paper Hand Towels <br />Soap dispenser <br />Culling tloanl i BleachPropane Stove <br />f. <br />Propane Tank <br />Cr <br />Sleinow/ChaKmg <br />Dish <br />Extra <br />V/.ilor <br />6 Gal Hand wash <br />Wastewater Container <br />Garbage <br />Can <br />5-20 Gal <br />Hand wash Water <br />Sanitizer bucket­ <br />bleach a waler for <br />storiny wiping dotlis <br />Booth must be on <br />Concrete, Asphalt. <br />Plywood, or a Tarp.r <br />Rinse Waler <br />SAN JOAQUIN <br />C O U N T Y <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 /> Refrigerated truck . * Ice bath and tubs <br />□ Other (specify) //[/\ <br />Title <br />i <br />Ema Icq Hags x / <>;<i Conlame/s inusi ha <br />sloit'l 6 Indies oil <>l tho groirw/l <br />Soup and Water <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420) F 209 464-0138 | www.sjcehd.com <br />El ID IG-02 Page 8 of 11 T EMP EVENT APP <br />07/3/17 <br />J wo <br />‘‘Important** <br />Ice Cooler | <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> Three compartment sink. /JI <br />O 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 />XJI <br />—jl <br />Names of responsible persons to be present in booth during all hours of operation: <br />r........ ............ <br />[ Health Permit <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my booth: ///A <br /> Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <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.zCN , .. <br /> <br />"Date