Laserfiche WebLink
Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br />-Q^Paper towels and pump-style soap container. <br />13. <br />Completed by:14. <br />Health Permit <br />Paper Hand Towels <br />Soap dispenser <br />Cutting Board <br />BleachPropane Stove <br />$ <br />Bleach and Waler <br />Fire Extinguisherfl <br />Ice Cooler <br />TEMP EVENT APP <br />Soap and Water Rinse Water <br />0Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />-Q One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> Three compartment sink. <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />Extra Ice Bags & Food Containers must be <br />stored 6 Inches oft of the ground! <br />Extra <br />Water <br />5 Gal Hand wash <br />Wastewater Container <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, ora Tarp. <br />J^TThree deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br />soltjiion (one tablespoon of bleach per gallon of water). <br />QDetergent, bleach, and wiping cloths (cleaning towels). <br />Q^Tub to store wiping cloths in bleach solution. <br />Sterne w/Chafflng <br />Dish <br />j, <br />bTl j <br />^present in booth during all hours of operation: <br />i—j i <br />6 -7 O <br />-V—Date <br />**lmportant** <br />— <br />Names of responsible persons to <br />SANJOAOUIN <br />------COUNTY------- <br />Greotness grotvs here. <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 />^5ce chests Refrigerator <br /> Refrigerated truck Ice bath and tubs <br /> Other (specify) <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjcehd.com <br />EHD 16-02 • Page 8 of 11 TEMP EVENT <br />07/3/17 <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 />thisevent^ J Jr ej-V, C-Jo'! 7 <br />Signature Title(S;L> .0^ <br />5-20 Gal. <br />____________________ v~ Hand wash Water <br />Propane Tank <br />4