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I <br />OR <br />12. <br />Nai <br /> 13. <br />Bbs thiSzewS^n A U \A A A * u \ <br />DateCompleted by.’14.Signature <br />Pap«r H«ndTow®UHealth Permit <br />CuUJno Board <br />Blaich <br />Propane Stove <br /> <br />i <br />IM <br />opane Tank <br />Ice Cooler <br />1888 E. Hazelton Avenue | Stockton, California 952051 T <br />I <br />II <br />6 Gil Hand wuh <br />WMtavMtorCofUalMr <br />Booth must be <br />Concrete, Asphi <br />Stemo w/Chifflnp <br />DI th <br />5-20 OaL <br />Hand waih Waler <br />Garbage <br />Can <br />■q Plywood, or alt <br />v’V ________ _ <br />Bleach and Walar l <br />"Important** <br />Title <br />all hours of operation: <br />SanlUzsr bucket- <br />bleach Swaiwtor UodngvdptaQCtolhs <br />B Soap and Water <br />Piro EaMnoulihar | <br />Soap dtpanter | <br />at/» lea Bafit 4 Food Confaiwa ffluaT t>« <br />tiond 9 oB ct Oia gtwndl <br />• 209 468-3420 | F 209 464-0138 | WW'8!^0^ <br />Environmental Hearn, <br />'-Three compartment sink.fesseses. <br />-——“ ”,h " <br />booth: P 5.20 ga||on container with spigot)- <br />^-Water supply dispenser with warm water at a minimum of 100 Fd-e-O- <br />»b or 1»»>'« <br /> <br />draper IowbIs “r'J oomo-sMa soap conialner. <br />^■O^' Grcotness grows here. , (nr lhe cold holdlna of potentially hazardous foods <br />10. I am providing the following cold ternPerBlure,c.onhr?inw 41 “F temperatljre)‘ <br />45OF (If food Is used the following day, maintain below * <br />4Xlce chests Refrigerator <br /> Refrigerated truck bath and tube---------------------------------------- ------------------------- -------- <br />H. I pm providing the foilovdng Items within my booth for the sanitary cleaning of food preparatton <br />for soapy water, one for rinsing and one for a bleach