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Ewfiironmf oiitall IHsulth <br />10. <br />OR <br />12. <br />13. <br />**mportant** <br />Slgnati <br />I Paper Hand Towel# <br />Soap dispenser <br />Propene Sthvo <br />- <br />Propane Tank <br />Rinse Waler Bleaoh and Water <br />Fire ExUnflUtsher <br />Ice Cooler <br />I <br />I <br />I <br />I <br />1 <br />Stemow/Chafflns <br />Dleh <br />Extra <br />Water <br />Garbage <br />Can <br />eHnillxer bucket- <br />bleach & water for <br />storing wfplno doth b <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />5 Gal Hand wash <br />Wastewater Container <br />1 <br />Water supply dispenser with warm water at a minimum of 100°F (l.e. 5-20 gallon container with spigot), <br />.una separate tub (bucket or basin) for the collection of rinse/wastewater. <br />I- <br />Title <br />—1ZZ <br />Goap end Water <br />14. Completed by: <br />SAN JOAOIJIN <br />COUMTV <br />Exira IM saga & Fbtxi ConlaInera nws! be <br />Btored 6 Inches off of the grourdi <br />one for rinsing and one for a bleach <br />Health Permit <br />2 Wilh,n booth for the unitary cleaning of food preparation utensil <br />£ deep tubs (basins 6-8 Inches minimum), one for soapy water <br />solution (one tablespoon of bleach per gallon of water) ' <br />LB Detergent, bleach, and wiping cloths (cleaning towels). <br />LB Tub to etore wiping cloths in bleach solution. <br />^pravldlng the following for edequete hand washing facilities, but separate from utensil wash within my <br />rt <br />--\r <br />K^f^apei towels and pump-style soap container. <br />Ni SP^X^n9 0 ln/^^irln9 a" h°Ur8 °f 0peratl0n: <br />4 <br />J <br />.vG^nests [Refrigerator <br />^frigerated truck |ce bafh an[j tubs <br />C] Other (specify)_____ ___________ <br />Un ?o nA Avenue | Stockton. California 952051 T 209 468-3420] F 209 464-0138 | www.ajaov.ora/ehd <br />ofl/ifl/i a paB0 6 of 11 TEMP EVENT APP <br />Date <br />6-20 Gal. <br />Hand wash Water <br />Bfaaoh <br />oh