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10. <br />11. <br />OR <br />12 <br />13. <br />’•‘Important**preparation <br />Completed by .1-1.[gnatnre <br />.XJl.n <br />• ■ <br />i <br />•,V • <br />I... <br />II <br />\\ <br />[ aii a'lf <br />(.an <br />I Ice Cooler <br />SAN JOAQUIN <br />< ' i. 1 ' : 1 <br />: u’l /• f I hi- * <br />t,I. .1 ’> f. <br />it..! ii; ; ■■■••a'. <br />V <br />Sb-iiO .’.A/i I <br />Hoot", mi.'4 He u:> I <br />Coiu.ii.-k’. /'‘■i.tinli ; <br />or *i 1 ;,,l' I <br />I'I... I... ' " <br />I... <br />IT <br />.. 11..... <br />waler al a n-wm of 100 I (i.e. 9*" S”i!l0,) <br />basin) foi the collection of nnsoMaslcwatei . <br />Environmental Health Department <br />| (..i:iii.,: I'o ..i ] <br />| Pi |.u? | i <br />| | lenlth Permit <br />c(; <br />| .-.v--.rv.ji <br />dnriiKj all boms of operation: <br />CZ...------- ----------- <br />ion- Ploaso'makc a’7opy of tins appiicat-<>n’<n <br />t |ini;,t be in the booth at all houib of <br />ya I coord .inatpHj.irecweck s. | > no i.. _ <br />S'-5'.': 23 <br />Date <br />,, I -. <iii ii.i .a ■' I <br />| \vi-i •:•■•■•■■"•••' | <br />L| , I ;.TO.UW.:m:'0| I- ZIW'UM okih ; A,„ <br />I.. I la.-dlon/Wi-ntu11 .>lo. I---"11 -r.iu-f'f’i <br />pit I U-IM <br />tor aorw waler, one (or rl'isinf, and one for » bleach <br />' day. ^ma^bdowdlT tonwaW <br />nice chests MlWiCforalor <br />^Hdrloaratcdma* I 11-bath and tubs __________________________ _ <br />| | Other (specify).------1 . ---------------------------------------- <br />..............................................——........................................ <br />I luce compartment sink. <br />................ ......................... ...... ...............-..........- <br />I ;im providing <br />booth. <br />yj Water supply dispenser with <br />One separate tub (bucket or <br />M Paper towels and pump-style, soap container. <br />Nmnos of responsible persons to bo present in <br />■■lorpodant".....All $AS^’itochockiisimos! <br />this event-. C) UC h .C^. <br />Title <br />I ?< 70 UM <br />... I 11x-d war.’*‘.V.i'. <br />i .f, ■ I..-ll ris 1.1 I>■■■•>’