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Environmental Health Department <br />12. <br />13. <br />"Important- <br />14.Completed by: <br />Health Permit <br />RWHMdlMkI- ]---Cu»iO Bowd <br />BtoKh <br />r <br />PnjpmeTwA <br />■evandWMr <br />Ice Cooler <br />.•G-7T77 <br />s <br />10. <br /> OwiMve <br />Can <br />Sigi <br />■—he Imutal btaKftawtarfcr <br />MutaaMpkeMia <br />Booth must be on <br />Concrete, Asphalt. <br />Plywood, or a Tarp. <br />one for rinsing and one for a bleach <br />to borth during all houm of operation: <br />I MhmMWw <br />■ QMHMdamh WMOMterOontoUr <br />OtamourfCfcrtr^ <br />DM <br />Title <br />MO CM. <br />V- I HMdMMhWMr <br />SAN JOAOUIN <br />‘ciFoi^'' CruatHuss yrows here, <br />“ "^sKssssssjjftsisssr b““ “«“~ <br />U other (specify) <br />I______M I C'wwreaaposreMfCMMiMMMMv I ^•e^oforaoZSr <br />g8E.Haze.ton Avenue| Stockton,CMM.9520^ T 209468-34201 P 209 4644)1387^^X00, <br />TBUD eueMT »nn <br />7 — <br />“W '*ator. <br />^providing the folfowing for adequate hand washing facilities, but separate from ut^l wash within my <br />Boater supply dispenser with warm wafaratamfalmumonoO'Ffl.e, 5-20 gaHon contain, with <br />Q^e separate tub (bucket or basin) for the collection of rineel^atowater. <br />Beeper towels and tamifratvie eoao container. <br />Names of respona■Jesus 7%.,