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►4 <br />Environmental Health Departr-- <br />10. <br />I <br />11. <br />OR <br />12. <br />□ Water supply denser wnwami water yt <•>< \xi-- , - ,v .v— <br />. J One separate tub (bucket or basin) for the ool'rvt on o' mse > nsteu.-t '■ <br />] Paper towels and pump style sp.rp contBinei <br />13. <br />** Important** <br />Completed by14- <br />WWMffW tVcvr <br />tsink. <br />,’p!> 464 | <br />A.'-.yV'’ ? -. <br />■ M. . ' - ' ■■■" <br />1868 I’. Hazel'oo Avenue | Stockion CahKxni.i Pb-Mt’s T ■l<4' .'4«.o I I <br />rimiro;’ rv»rtii <br />ur.-.v i <br />SAN JOAOUIN <br />— COUN Tv------ <br />j Ice Cooler | <br />Ml food vendor booths are sd^ect to i ispectK^i'- Pteax -ak;-a ca-' wv■-■- v <br />pr eparation for this event. A copy of i . s iTiock.- s-. -us! he ■ 'v ixv-.- <br />preparation and operation. Return original to festivid nynfinMc: <br />this event. s <br />Signature <br />1 am providing the following ite-s within mv booth v "ie s= ■ . - y ■ ' to-c <br />O Three comparfrnent sink. <br />| ! leaith Peri’iif 1 <br />I am orovidinq the foflowing ccMd temperaturr rr ■ for for zok: *; v ; .'c ■c: ■ c..vw..- heo., <br />45-*F I if food is used the krfien-mg day mainte F <br />Fl Ice chests j Reftigerator <br />[T Refrigerated Stuck I I Te bath and tubs <br />C? Other (specify) . - ----- <br />O Three deep tubs (basins 64B inches nrinmum) orte to: soarv ■ <br />solution (one tablespoon of bleach per gaBon of wale. > <br />n Detergent, bleadi. and wiping cloths (cteanmg tewefe) <br />EJ T ub to store wiping cloths in bleach solution. <br />1 am prcv.cinc the follow ng for adequate ’vmc sv.-.s’vnp b. ; 'w . :-?w . ■ - - <br />booth: <br />Names of responsible persons to be present in booth during all boons • ep<? <br />______ZVv\>q.y-^ pt-'Via.iv t Vvk< aJk. u.u 3£Lv-2i__ s. v_ ■.