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VrOM FAX NO.H. 27 2013 6:37AM P3 <br />lO- <br />ll. <br />OR <br />12. <br />13. <br />^'irnportao t”A copy <br />Signature14. <br />Paper Itand Towe'S <br />CuttAg Baa’d aPROPS’*: Stove <br />PfOfiane Tank <br />S^stxj Waler <br />Fin; ExbngHEtar <br />Health Permit <br />5 G3< Hand <br />Ccntaines <br />Booth must be on <br />Concrete, /tsphatt. <br />Plywood, or a7atP- <br />Hand wadi W1®3 <br />Garbage <br />Can <br />/ Exira \ <br />Waler I <br />f <br />VrtJc <br />S^nittax boekct- I <br />tucjch&swaieftoi I <br />sturkw) w'.pirra ctoihs <br />SANoJ0ApMIN <br />; ice Cooler E^ic^Ba^AFaodCofM^f^^ E <br />3?ojt*l 6 metes offoJ ff» arountZ <br />1868 E. Hazelton Avenue | Stockton. California 952^[ <br />U7/3/17 <br />Environmenu! Health Oep^^ <br />-| T 209468-34201 F 209 46M13S | <br />PagnBoril <br />1 45«F0ffood is usedC^ek>lto*^9^y- maintain below PrjtentiaBy bazaraous toodB betow <br />' and tubs <br /> other (specity)—.— - — - - - ----------- ------------ ------------- <br />■Hina the following rtefn3 wrthin boottl ctea’w,g of food preparatKin utensil <br />^Xe'^amiontslnk. <br />, tubs (basins 6-8 inches mini mum), one far soapy water, one for rinsing and one for a bleach <br />“““ <br />following for adequate hand washing facilities, but separate from utensil wash within my <br />I am providing the <br />booth: <br /> Water supply dispenser with warm water at a minimum of 100“F (i.e. ^20 gafton container with spigot). <br /> one separate tub (bucket or basin) for the c^tectfon of rinseAvasfowater. <br />^fpaper towels and gurne^tyfesoag container. <br />Names of responsible fxwsons to be preset in ttoath^ng V). , Uff y/W-U <br /> <br /> <br />_______—---------TTTnZTrn insoecuon. Ptease make a copy of this application in <br />All food vendor booths are su J checWist must pe in the booth at all hours of <br />preparation for this original to feotivid cooixitoafmjtroy. weeks prtorjo <br />thSev^ 4^ 6^-/1-^' r Iil l^c<9 <br />, bv- ---------------------------------------------------------------------- -----------------tote <br />Cornplet^ &¥- ------------