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Environmental Health Department <br />io <br />OR <br />12 <br />13 <br />14.Comply by. <br />Health Permit <br />1 <br />Scanned with CamScanner <br />Hana <br />*»*««> 4 Mkv V <br />MX*'® «pna aurw <br />o- <br />Ice Cooter I <br />r MHIC* * r«M CMMNM ■■■ •• <br />«u»l « <br />I am ptc'-ndna the loilowmq cow temperature control fw the cold holding of potentially hazardous foods below <br />AST (tf toon is used the foUcwvng day maintain below 4IT temperature) <br />chests Refnqerato' <br /> Retngerated truck | ] ice batt) and tubs <br />U Othei (specify I ____________ <br />I *ww Sjgov org.‘ehd <br />TFMP fVtNT AFP <br /> Boom mmt e« on <br />Conorvte A*phait. <br />^♦vxocxJ. o» a Tarp <br />SAN JOAQUIN <br />I •> G® 1 <br />I ■»»««,a<, <br />te(C. <br />~Tttte <br />in booth during an hours of operation <br />1868 E Hazelton Avenue i Stockton. Catfomia 95205 | T 209 468-3420 | F 209 464 nna <br />tKI 16 W Maaa«M — v.jo <br />(W/.'W-.-CIJ <br />ate sut-iect to inspection Please make <br />-.1 A copy of this checklist must be <br /> Gaifcaga <br /> Can <br />— HI Lr\>r<wtA <br />“important- <br />tollo'*nr’9 ,Of ade<?uate hand washing faakbes, but separate from utensil wash wtthn my <br />1 ---------I L — i-n.y <br />| Caanaiaanl | <br />«V4MT» 1mm <br />____________________________________________________________________________________________\ , — ■ <br />I I’tea-I) <br />I I <br />three deep tubs (bairn 6-8 inches minimum), one for soapy water one tor nrsmg and one for a bleach <br />soivibon (one tablespoon of bleach pm g.sllon of water) <br />f' "-etergent bleach, and wiping ctoths (cleaning towels) <br />J uh to store wiping cloths in bleach solubor <br />1 provid-ng the ’o^icwing items wthm my booth tor the sanitary cleaning of food preparation utensB <br />I j Three compartment sink <br />_J <br />I SWM4W*. <br />1ocK3|vCf^Of a'c ^biect to inspects Please make a copy of th« appication n <br />>■ era aton <c\n''5 A copy of this checklist must be n the booth at arbours of <br />ths Bgtyn) Sxtginal to festrval coordu>aU>r thr»e week, prior to <br />___________L-^—- • •__________ b"' f' NhA t FA- 7- lz-7 ) 1 u <br />Signature 7^ ’ <br />‘^ater supply dtspenser wth warm water at a mmimum of 100T (i e 5-20 gallon container wtth sp^ot) <br />j>One serai ate tub (bucket or basim for the coliecbon of nnseNvastewater <br />U^aper towels and pump-style soap container <br />Names of responsible persons to be present