Laserfiche WebLink
Environmental Health Department <br />10 <br />12. <br />13. <br />Completed by: 14. <br />Health Permit <br />Paper Hand Towels <br />Soap dispenser <br />Cuttinp Board <br />BleachPropane Stove <br />Propane Tank <br />Fire Extinguisher <br />1868E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | <br />06/W1B Page 8 of 11 <br />Soap and Water Rinse Water <br />Stemo w/Chaffing <br />Dish <br />5 Gal Hand wash <br />Wastewater Contains <br />Garbage <br />Can <br />Sanitizer bucket­ <br />bleach & water (or <br />stonng wiping cloths <br />5-20 Gal <br />Hand washWater <br />Extra <br />Water <br />Title <br />Exira Ic« Sags I Food Containers must be I <br />stored S Inchos off of the ground' <br />"Important** <br />SAN JOAQUIN <br />COUNTY <br />Greolness grows 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 />Ice chests Refrigerator <br />□ Refrigerated truck Q |ce bath and tubs <br />□ Other (specify) <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />ww.sigov.org/ehd <br />TEMP event ap <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 />Signature Title Date <br />am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />I Three compartment sink’’ $ <br />OR <br />□ Three deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br />solution (one teblespoon of bleach per gallon of water) <br />D Detergent, bleach, and wiping cloths (cleaning towels) <br />□ Tub to store wiping cloths in bleach solution. <br />£5. Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />53 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 />A /£> ____________________——- <br />Ice Cooler