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OR <br />12. <br />"Important" <br />Date <br />Health Permit <br />Bcacr <br />:iihnl <br />gteHxng <br />Sto^o^o-r**; <br />SkvMXB/UK***- <br />DUacil .»Uf tar <br />«Jorrcm*^cSeffw <br />yi <br />w e <br />E <br />o <br />i <br />■S o <br />f-* <br />S’ <br />f <br />I <br />cbI <br />o <br />b o <br />JI <br />O’ <br />c <br />$ <br /><2 X <br />-O <br />n x x <br />3 <br />2 <br />I <br />§ <br />in <br />Z <br />X' <br />■D <br />s. <br />o 5 ?— <br />3 S tn g) IQ <br />0>I <br />5 <br />p <br />1868 E. Hazelton Avenue | <br />EHD 16-C2 <br />07/3'17 <br />Ga.H>»;o <br />Can <br />Ice Cooler J &*« U. t KM CUOiwa «» “• <br />Stockton, California 952051 T 209 466-34201 F 209 4^38 | ^.sjcehd.^m^ <br />as <br />I C-Pttux I <br />P-oo«.. Su« .Booth must be or. <br />Concreta. Asphalt, <br />pywxxl.or a Tarp. <br />| SaMaw*, | -------------- <br />5 Gd M<n<S ---------- <br />tUU CVA >. • ------ - • • <br />A copy of this checklist must be in the booth at aft ..— ~ <br />J original to festival coordinator three weeks pnor to <br />tllle * ' ' <br />$■20 Get <br />r KCZ.t .3^ «rjr <br />J^Water supply dispenser with warm water at a minimum of 100‘F (Le. 5-20 gallon container with spigot). <br /> One separate tub (bucket or basin) for the collection of hnse/wastewater. <br />J2^aper towels and pump-style soap container. <br />13. Names of rosp^tle parses t^bo preS6r'X^^'^^g 3,1 b0Ureoperafen:_______ ______________ <br />All fooa vendor booths are subject to inspe’cton. Please make a copy of this appl^tiorTin <br />STevent ‘ * <" *e at °f <br />preparation and operation. ■ <br />this eventx^) // <br />14. Completed by. <br />■.> wja <br />• • 45’? (rf food is used the following day , ma'ntxn becw 41'r ten <br />■ • 3J.rochests • □Refrigerator. <br /> Ice bath and tubs <br />1irVt t I <br />. . SANs-lOAtjUlN Environmental Health Department I <br />1$$? ~—EOLW'lTV--— I. I....."iti ’'i^'prT^.dIngthe'W!<>drx7 cddtemperatjraromro. for tre co d holding of pctenta.lynazamcus foods below | <br />, <br />□^Refrigerated truck Ice bath and tubs <br />I □ Other (specify).--------------------------- -------------------------------------------------------------------------------------------- <br />I • ■■ <br />11. lap-providing the folowing Items within my booth for the sanitary cleaning of food preparation utensil <br />0 Three compartment sink. <br /> Three deep tubs (basins 6-8 Inches minimum), one for soapy water, one for rinsing and one for a bleach <br />solution (one tablespoon of bleach per gallon of water). <br />IZpelergent. bleach, and wiping cloths (cleaning towels). <br />J/jTub to store wiping cloths In bleach sotuticn <br />I am pmvtong the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />IS