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1600 - Food Program
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PR0541020
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COMPLIANCE INFO
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Entry Properties
Last modified
7/10/2026 4:46:41 PM
Creation date
7/8/2020 11:48:04 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0541020
PE
1695 - TEMPORARY EVENT
FACILITY_ID
FA0023482
FACILITY_NAME
RESTAURANT ON WHEELS
STREET_NUMBER
25
STREET_NAME
MAIN
STREET_TYPE
ST
City
MOUNTAIN HOUSE
Zip
95391
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\tchampion
Supplemental fields
Site Address
25 MAIN ST MOUNTAIN HOUSE 95391
Tags
EHD - Public
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ji <br /> I <br /> 10, 1 am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 45* (if food is used the following day, maintain below 41 OF temperature): <br /> Ice chests ❑ Refrigerator <br /> []Refrigerated truck [j Ice bath and tubs <br /> ❑Other(specify)__ <br /> 11, 1 am providing the following items within my booth forwarewashing: <br /> ❑ Three compartment sink, <br /> OR <br /> Three deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br /> solution(one tablespoon of bleach per gallon of water). <br /> 12, 1 am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br /> Detergent, bleach,wiping cloths(cleaning towels),and a tub to store wiping cloths in bleach solution. <br /> 13. 1 am providing the following for adequate hand washing facilities, but separate from utensil wash within my booth: <br /> -0 Water supply dispenser with warm water at a minimum of 100OF (i.e. 5-20 gallon container with spigot). A <br /> separate tub (bucket or basin) for the collection of rinse/wastewater. Paper towels and a pump-style soap <br /> container, <br /> 14. Napes�-f res onsl� "Ale persons to b� resent in booth during all hours of operation: <br /> **Important** All food vendor booths are subject to inspection. Please make a copy of this application in <br /> preparation for this event. A copy of this checklist must be in the booth at all hours of <br /> preparation and operation. Return original to festival coordinator three weeks prior to <br /> this 999n . <br /> 16. Completed by: r� Jf l <br /> tg a urc� Title Date <br /> 5-20 Gal, <br /> i <br /> Hand wash Water <br /> Health PerrnitJjl <br /> Stereo wlCltalCng 1 <br /> Dlstr <br /> Papef Hand Towels <br /> 1 <br /> - Soap dispenser <br /> Culling Board Sanifter bucket- I <br /> Mearh&wale W <br /> Propane Stove <br /> Bleach slorhtg wiptno dolhs <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> TP <br /> PropanaTank -- _- -.. .. ......... - - :.. —._.... _ <br /> ------------ <br /> Soap and Water Rios e Waler oleach ww wator Garbage <br /> Can <br /> �. fire Exttnpidsher <br /> water <br /> Ice Cooler �� t' - 5GnlHandsresh <br /> Extra ice Bags d Food Containers must bo Wastewater comainef <br /> - -----•---- -•_ stored 6lnchos oil of Me Vim <br />
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