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5:27PM No. 0324 P. 4Aug. 1 1. 2021 <br />Environmental Health Department <br />10. <br />11. <br />OR <br />for soapy water, one for rinsing and one for a bleach <br />12. <br />13. <br />“Important*’ <br />14.Completed by: <br />Title <br />Health Permit <br />Paper Hand Towel a <br />Culling Board <br />Propane Slave <br />JI <br />Soap and Waler Rlnee Wa^r Bleach and Waler <br />ml <br />Fire BtiinguHher <br />Ice Cooler <br />EHD?e.o2Ha2elt0nAVenUe| StocKton, California 952051 ^209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />Received Time Aug. 1 1. 202 1 TEMP EVENT APP5:15PM No. 6859 <br />6 Gal Hand wash <br />Wastewater Container <br />Exira <br />Waler <br />5^2D Gal. <br />Hand wash Waler <br />Sanlllzer buckel- <br />bleacfi & water for <br />atoring wiping dolhs <br />Extra Ice Bags S, Food Conlalaers must ba <br />stored 6 Incnes off of the groundl <br />8 Lerna w/ChelTlng <br />Dish <br />^| 4 <br />Signature <br /> ThZ'"*hln mV b00th for lhe sani,a,y dean^ <” flatten utensil <br />Garbage <br />Can <br />Prtjpano T ank <br />------------------------i <br />,8/11/2021 <br />Date <br />>■ <br />I am^providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />^Water supply dispenser with warm water at a minimum of 1 GOT (i.e. 5-20 gallon container with spigot). <br />0 One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />M Paper towels and pump-style soap container. <br />Names of responsible persons to be present in booth during all hours of operation: <br />Yoana Throne, Marvin Williamson,. Ben Keller, Tim Ng, Linda Wilcox, and Harold Reich <br />O Three deep tubs (basins 6-8 inches minimum), one <br />solution (one tablespoon of bleach per gallon of water). <br />B? Detergent, bleach, and wiping cloths (cleaning towels) <br />LJ Tub to store wiping cloths in bleach solution. <br />x <br />Booth rnusl be on <br />Concrele, Asphalt, <br />Plywood, ora Tarp. <br />- SANJOAQUIN <br />'-Y-- "1 ------COUNTY------ <br />Greatness gro^s here. <br />' ' 45T?if S i?°ld te™perature COlltro1 for the coW holding of potentially hazardous foods below <br />45 F (if food is used the following day, maintain below 41 °F temperature): <br /> ice chests M Refrigerator <br /> Refrigerated truck |ce bath and tubs <br /> Other (specify) <br />?mOthS a? SUAbieCt to 'nsP.ection- Please make a copy of this application in <br />preparation and opVaS.’ Return oriXl^fest^Tcoo^dinator thre^weete S to <br />tn is event, z—~ <br />Soap dispenser <br />Gleacn