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I <br />10. <br />I11. <br />OR for a <br />12. <br />13. <br />**important*’ <br />Completed by:14. <br />Health Permit <br />Papw hjcjJ I cwvli <br />Soap<itp<wi»er <br />[ Culling Boo'd <br />Bleach <br />Propane Slov* <br />I <br />Bleach and Watt*Soe^ and Water <br />Hrt&awMiw <br />0 <br />BA*lOtBiQilFood Cw^tbw musl I <br />ctonrftiKftMtfafPw pwfflJf L <br />Extra <br />WMf <br />5Gai Handwash <br />WasttwaW Contain* <br />Gaibage <br />Can <br />Booth must be on <br />Concrete. Mphatl. <br />Plywood, or a Tarp. <br />Santaor buciml- <br />U4i*cn a «ate( 1« <br />*tcnnq *rtfckivn <br />5 20 GbL Hmuj wash Wat* <br />SAN JOAQUIN <br />( O l i N I Y <br />O Three deep tubs (basins 6-8 inches mininMiin). on<< f <br />solution (one tablespoon of bleach per gallon of water) <br />O Detergent, bleach, and wiping cloths (cleaning towels) <br />O Tub to store wiping cloths in bleach solution. <br />RinteWWar <br />3k <br />___nOAIU4)l38 I ww.«i«W«» <br />Slamo w/Chafflnfl <br />DWi | <br />preparation for this event. <br />preparation and operaU^W; <br />this evei^tr^7 <br />Signature <br />. ............. Ho* 0°Pa',me"‘ <br />I am providing the following for adequate hand washing facilities, but separate from utensil //ash <br />booth: <br />t^Naler supply dispenser with warm water at a minimum of 100T (i.e. 5-20 gallon container with spigot). <br />J^'One separate tub (bucket or basin) for the collection of rinse/wastewater <br />0*Paper towels and pump-style soap container. <br /> <br /> <br />are <br />^Returq^drlqinal t^/festivat coordinator three weeks prior to <br />Zc Z 5 <br />Title Date <br />pfrprwvidtng the following Items within my booth for the sanitary cleaning r>f food preparation <br />Three compartment sink. <br />' ' ^us foods below <br />I am providing the (nllnwinp <x,W lemp«n»iwr« cnnlrnl frw the cokl hnl.hnq -.f pctnntlnlly ^'n/' <br />45*T (if fcxxf is used the fnlkAving day, jpnint«*n bnkiw 41*r tAniper.-rtura) <br />O foe chests Refngmntrw <br /> ReMgemted truck ( ] tee bnlh and tubs <br />fl Other (speedy) —------------------------------------------------------------------------ ' <br />for soapy watnr one- for rin'ung and one