Laserfiche WebLink
Environmental Health Department <br />10. <br />11. <br />OK <br />separate from utensil wash within my <br />12. <br />13. <br />Important** <br />M. <br />I <br />l ‘ <br />XI <br />Booth nwsl bo on <br />Concrete. A-.pl mil. <br />I -lywoocl. or n fnrp. <br />V.’.r.K C-'.’.' ■ <br />riaibngo <br />Can <br />SAN JOAQUIN <br />< ( it IN I Y <br />| ! n ip <br />I k«i I V ••■J.' <br />| I'loi.h <br />(Ice Cooler <br />5 20 <UI I <br />ll.indw."l>W.>lu' <br />• : '.■Ji'.’.' <br />jl ....‘J »n: Vt. <br />Ctlivny Ik'ixl | — . <br />■fer2-■ 2 v| I'm a.r 1 <br />l <br />| I t.ij V>" .'•• <br />| I’ j | .. | <br />/ r ••m \ <br />[ W.it<w | <br />I. . . J <br />I Health Permit |'l r <br />1 ------------- lll'h | <br />X Water supply dispenser with warn, water at a nrlnimum ol 100T (l.e. =-20 ga«on container with spigot). <br /> one separate tub (bucket or basin) (or the collodion of rlnso/waslowaler. <br />Paper towels and pump^style soap container. <br />Names of responsible persons to bo present In booth during oil hours of operation: <br /> ____—--------------------------------------------------------------------------------------------------------------------------- ------- <br /> <br />Comp1cledby:_^Sfe=Z^=------- —------- <br />[ <br />| ficnsp 0 sper.W | - <br />[ I'l.por II.KMllO'ACb | <br />r..in t ?e/l>u< k'l I <br />tloKh & »..«<»> ler I <br />itonnq w P"'O •J"'"'. <br />, ™ proving the foHowmg cold temperature control for the cold hold.ng of potency hazardous foods be.ow <br />‘d'PF (if food is used the following day, maintain below 41 f- temperature) <br />[J Ice chests ^Refrigerator <br />| J l^ofrigeralcd truck I I,cfi batl1 a,Kl lubs <br />[’I Other (specify) <br />I am providing the following items within my booth tor the sanitary cleaning of food preparation utensil <br />pi’lhrcc compartment sink. <br />n Throe deep tubs (basins 6-0 Inches minimum), one for soapy water, one for rinsing and one for a Pleach <br />solution (one tablespoon of bleach per gallon of water). <br />jXDetergent, bleach, and wiping cloths (cleaning towels). <br />Tub to store wiping cloths in bleach solution. <br />I am providing the following for adequate hand washing facilities, but <br />booth: <br />...........;> «.»—•«' 1 —ess- <br />I HU !<■ IV <br />< • 1 1/ <br />