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Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br />j :.j: ■ <br />ilner. <br />13. <br />14»C.'. <br />Paper Hand ToumU <br />t e»sp dlsnsnwr ' <br />Propr: Y:-r± <br />HLiachandWaia- <br />1 <br />J <br />tU20 .'301. <br />Hurt WMb Wato ’ <br />i* <br />jGiiHinoudwi <br />v«-. .-vjaief container <br />sanfitzarbuckoV <br />bleach A wterfkx atorinfl viiplng doth* <br />Booth must ba on <br />Concrete. Asphalt <br />Plywood, or a Terp. <br />i In ooom during ail hourt erf oparaUon; <br />Gfirtssga <br />Can <br />lE'-SB E <br />07/0lfi6; <br />ns <br />r ■- —T <br />. Sfeadi s <br />. cii Ai. of 100°F (|.e. 5-20 gallon container with spigot). <br />L One ? a . 'aucsket or has,a) fcr the collecte of rinseMastewater. <br />k <br />.—... <br />»MPW8^ <br />; ■ ’ " ;'’1:far F-decjuatd hand washing facilities, but separate from utensil wash within my <br />-...ax i <br />i <br />- ... itams Hy bootii for the aantery oteanlQg of food preparation utensil <br />*•“*• H. .>i«m <br />' rdWrtir ' <br />------ — —— I <br />R-u ecinp.u>SB6r ■ <br />- J <br />-----COUNTY----- <br />•.- 'sern; 5- (>rpvr< -h.r <br />a>!d tenpaitaB control for fha cold holding of potentlslly hazardous foods below <br />> ? : j.ii.i:'; : jhalntsln baicv 4105 fernpersfejra): <br />Sn>m0erator <br />Jj lce| bath and tubs <br />Cac: i .ii 515205 i s 2ua4€a“3420| Ir 209 464-0138 | www.sjgov.org/ehd <br />Pt-fia ? ct11- T 5MP EVENT AFP <br />J - J 2;- s (basins ^8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br />4_.. ... . .'J.--. f goi 3n of wafer). <br />y -8 • .■'.£.•« Xf:; ^(ceanlngtnwBls). <br />' - - -. A''irig oiouif in bisa-;n soil jtfai. <br />y mciti ic £\ ^reseiit <br />v:;-n <br />v> ndor -. • s^effi toTnspe^on. Ptease make a copy of this application In <br />■c aLuj for oua evant A copy of this checklist must be In the booth at all hours of <br />yfalnai to fasftral CTO^Irk-. . . .•.- Aii-se v/aeks prior to <br />■•"rtfo Dat® <br />- - - <br />.•■•j j-cvcn, Gauar«il~Jr <br />•> >- "j. <br />'• <br />' -m providing <br />eh&sis <br />2.;’. ■ •.;-L.-xc <br />£ j Oil'isr (s