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IMG_20240213_031010_886.webp (108C 20) <br />SAN JOAQUIN Environmental Health Department <br />io <br />ii <br />OR <br />12 <br />Paper towels and pymp-setie soap container <br />13 <br />"Important" <br />Completed by <br />Signature <br />i Health Permit V <br />3 n«r» <br />J <br />Ice Cooler <br />F 46-|. I'nn <br />1/1file:///C:/Users/hburkhart/ApDData/Local/Microsoft/Wlndows/lNetCache/Content.Outlook/l69P5H16/IMG 20240213 031010 886.webp <br />-y <br />PM <br />5-^r vmi 'VW.. <br /><o ttoQ* < c-’*' Cc*r»,»rv*<M ’»».n <br />4 'xt-u * V '•« f’rtftt1 <br />jr <br />0 Three deep tubs (basins 6-8 inches minimum), one for soapy waler, one for rinsing and one tor a bleach <br />solution (one tablespoon ol bleach per gallon ot water) <br />□ Detergent, bleach, and wiping clolhs (cleaning towels) <br />□ Tub to store wiping cloths in bleach solution <br />I am providing the following tor adequate hand washing facilities, but separate from utensil wash wtthin my <br />booth: <br />Gart>»Q« <br />Can <br />Boetn m.u ca w <br />Cooc/sts a»maii <br />Plywood o' a Tarp <br />N m<—.>«-• "wmjww« <br />.va7/ ij.juv jrg-ti'hd <br />r£MP e-.-e.NT Apnz. -‘azelton A/orm <br />ewe •& o? <br />M <br />®Water supply dispenser with warm water al a minimum of 100’F (i.e 5-20 gallon container with spigot) <br />f^Jne separate tub (bucket or basin) lor the collection ot rmserwastewater <br />Stockton C3iifcmi.i ?52O5 ! V 2i59-i»i«-3-l.?> <br />Oau. 1 4 <br />I am providing the following cold temperature control for the cold holding ot potentially hazardous foods below <br />45°F (it lood is used the following day. mania* below 41 ’F temperature): <br />□ ice chests QjRefngerator <br />[^Sefrigeraied truck O Ice bath and tubs <br />□ Other (specify) ......———— ------------------------------------------------------------- <br />All food vendor booths are subiecl to inspection Please make a copy ot this application m <br />preparation lor this event A copy of this checklist must be in the booth at all hours ot <br />preparation and ooeration Return original to testivpt coordinator three weeks prior to <br />this event. <br />Names ot responsible persons to he rvesp'ii m booth during all hours Ol operation <br /> Kristina Ruiz - - <br />lam providing the following items within my booth lor the sanitary cleaning of food preparation utensil <br />®Three compartment sink. <br />Date