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EHD Program Facility Records by Street Name
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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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f <br /> 'v <br /> • t <br /> l <br /> t £ <br /> s <br /> 10. 1 am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 46*F(if food is used the following day,maintain below 41*F temperature): <br /> it <br /> ❑ Ice chests [vJ'Refrigerator s <br /> ❑Refrigerated truck ❑Ice bath and tubs <br /> ❑Other(specify) { <br /> :l <br /> 11. 1 am providing the following Items within my booth for warewashing: <br /> 3 <br /> : u <br /> (�Three compartment sink. 5 <br /> OR <br /> [v 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), t <br /> U. I 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 /> l <br /> i <br /> 13. 1 am providing the following for adequate hand washing facilities, but separate from utensil wash within my booth: <br /> [A water supply dispenser with warm water at a minimum of'100*F (Le, 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 r <br /> container. <br /> r ; <br /> - 14. Names of responsible persons to be present in booth during all hours of operation: <br /> Sam Hissayko <br /> f <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 orlainal to festival.coordinator three weeks Prior to � <br /> this event. <br /> 16. Completed by: 04/15/2016 <br /> ignature Title Date <br /> 5.20 Gal. <br /> Health Permit Hand washWaler 7 <br /> �����JJJJJJ <br /> Slorno wJ-haffing <br /> Dish <br /> Paper ttand'I'ovrefs <br /> Soap dispenser <br /> Cullklg IIoard 3anigzer bucket- :G <br /> bleach d%valor for <br /> Propane Sfove BF staring wiping clallts yy <br /> Booth must be on s <br /> Ce"reto,Asphalt, <br /> ��tywood.or a Tarp. <br /> Ml- <br /> i <br /> Soap and Water Hfnse Water Bleach and Water Garbage i <br /> Can <br /> �. Fire ExOnatilshor <br /> Water <br /> Ice Cooler I a::;;:.sa:=..:.:•.1,;• . <";;:<.il,::G':'::':1'' F. 6Gaf Hand wash ---- { <br /> J Exfra ice Haps d Food C.onlainers mr.sl he Wastmvater Conlainar 1f <br /> !y Y <br /> 3 8 <br /> 3 t <br /> EHD 1H-02 Page a of 11 TEMP EVENT APP <br /> 7114115 t <br /> i <br />
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