Laserfiche WebLink
<br />Environmental Health Department <br />Ulb <br />11. <br />OR <br />12. <br />13. <br />wntey Tep, Ti <br />"Important** <br />Completed by: 14. <br />Health Permit <br />Paper Hand Toma <br />Scap dipcmcr <br />CuCnoBo-TO <br />Propau Stove <br />3 <br />r^n Exlnajflhef <br />Ice Cooler <br />Santear tucfel- <br />taaam i tor <br />texng wpaTQ ctoffn <br />tilra ca Hjqi C hxx> ConTanen mo be <br />Semi 6 inc/Kt eft at the grama' <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> Three 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 />S Detergent, bleach, and wiping cloths (cleaning towels). <br />"M Tub to store wiping cloths in bleach solution. <br />Ejtra <br />Water <br />Garbage <br />Can <br />Sterno »«Cha/frg <br />Dnh <br />5 Gal Hand wain <br />WaUrvalir CtxMaoei <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />Booth must be on <br />Concrete. Asphalt. <br />Plywood, or a Tarp <br />SAN.J0A0UIN <br />COUNTY <br />Prcoana Tank <br />10 lam providing the following cold temperature control for the cold holding of potentially hazardous foods below <br />4!?OF (if food is used the following day, maintain below 41 °F temperature) <br />In Ice chests Refrigerator <br /> Refrigerated truck Ice bath and tubs <br /> Other (specify)_____ <br />1 <br />RrwWJa <br />7 <br />Soap and <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 />VP oT Ms 2/22/202 ? <br />Signature ' Title Date <br />5-JO Gal <br />Hand waah Water <br />Bleach <br />1868 E Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www sjgov org/ehd <br />EHD 1&-02 Page 8 of 11 TEMP EVENT APP <br />06/10/19 <br />J U OUJ <br />^gl <br />j^Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />^^One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Paper towels and pump-style soap container. <br />Names of responsible persons to be present in booth during all hours of operation: <br />V~Tcp,'~Firn QaSiSZ.__________