Laserfiche WebLink
p. <br />Environmental Health Department <br />10. <br />11. <br />OR <br />12.my <br />B^Paper towels and pump-style soap container. <br />13. <br />14.Completed by: <br />Title <br />Health Permit <br />Paper Hand Towels <br />Soap dispenser <br />Cutting Board <br />Propane Stove Bleach <br />.-.4'Xn <br />Rinse Water Bleach and Water <br />Fire Extinguishera <br />Ice Cooler <br />Page 8 of 11 <br />Soap and Waler <br />Extra /ce Sags & Fooct Containers must be <br />stored 6 inches off of the groundl <br />Sterno w/Chaffing <br />Dish <br />Extra <br />Water <br />u ■ <br />Garbage <br />Can <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping cloths <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />5 Gal Hand wash <br />Wastewater Container <br />5-20 Gal <br />Hand wash Water <br />Signaturey <br />]dd <br />Propane Tank ------------- <br />“Important** <br />pThree co^np^rtm01'0^0 k'161713 W'th'n my b0°th sanitary c,eanin9 of food preparation utensil <br />t <br />07If 9 <br />Date <br />B Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />B One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within <br />booth: <br />J <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 /> Tub to store wiping cloths in bleach solution. <br />SANJOAOUIN <br />------COUNTY------ <br />Greatness grows here. <br />1 the fCT.O9,cold temPerature contral f°r foe cold holding of potentially hazardous foods below <br />45 h (If food IS used the following day, maintain below 41 °F temperature): <br />fS'lce chests 0-Refrigerator <br /> Refrigerated truck ice bath and tubs <br /> Other (specify) <br />ehdw-02 Hazelton Avenue I Stockton, California 95205 | T 209 468-3420) F 209 464-0138 | www.sjgov.org/ehd <br />06/19/19 Page 8 of 11 TEMP EVENT APR <br />Names of responsible persons to be present in booth during all hours of operation: <br />----Lucut_tePi no-ZG ; ■ J Hem Fr-gaco iceriq <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 andoneration. Return original to festival coordinator three weeks prior to <br />this event. X / // ---------