Laserfiche WebLink
Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br />13. <br />Important** <br />14.Completed by: <br />Title <br />Health Permit <br />Paper Hund Tcwali <br />3oep dSsparger <br />CuHInq BoaiS <br />Prunano Stove Blench <br />lb Prppnne Tank <br />Fine ExtlnRulBtw <br />Ice Cooler <br />i <br />Star no w/Chafflng <br />Omn <br />Ijkire <br />Wn'er <br />5 Gal Hand wash <br />Wstlowater Contalnor <br />Garbage <br />Can <br />£«1ra S Food Corrtflnors mu at bv <br />tirypd t ineftes off of thf arw/ndl <br />5-20 Gal, <br />Hand wflah Water <br />Sanl(t?er buekai. <br />bleach & wator for <br />Blotlng kvfsl.-ia dolhs <br />SAN JOAQUIN <br />-----COUNTY - <br />□ Three WWlln b0Q,hCte0ni"9 of ^nsll <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />Rinse Water <br />Title Date <br />.O' <br />— ''1 <br />^providing the following for adeqljate hand washing faDi|lt|eSi but SBparale from wgsh <br />^Water supply dispenser with warm water at a minium of 100’F (l.e, 5-20 gallon container with spigot), f <br />One separate tub (bucket or basin) for the collection of rinse/wastewater. <br /> Paper towels and pump-style soap container. <br />Names of n <br />' «-rSS “rSSSS" <br />J^lce chests □Refrigerator <br /> Refrigerated truck Ice bath and tubs <br /> Other (specify) <br />n tn^t^nn w 5? Sb^ la lnsPec,ion- Please make a copy of this application^ <br />D eSon and LT o “Py °1 'hiS CheCWiSt miJSl be in tf1S b00,h 3t h°ure °f <br />prepar^y andoperation. Return original to festival coordinator three weeks prior to <br /> <br />Signatur^ <br />end w-02 HazelIon Avenue 1 Stockton, California 95205 I T 209 468-3420] F 209 464-0138 | www.sjgov.org/ehd <br />rwiflflt* Pogo 0 of 11 TEMP EVENT APR <br />for SOapy one fbr a bleach <br />DjDetergent, bleach, and wiping cloths (cleaning towels). <br />])ffrub to store wiping cloths in bleach solution. <br />on^blep^^^^resent in booth during all hours of operation: <br />7 <br />6o8P »nd Water