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COMPLIANCE INFO_2024
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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CENTRAL PARK
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1600 - Food Program
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PR0541099
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COMPLIANCE INFO_2024
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Entry Properties
Last modified
3/27/2025 1:31:28 PM
Creation date
3/27/2025 1:29:36 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2024
RECORD_ID
PR0541099
PE
1695 - TEMPORARY EVENT
FACILITY_ID
FA0023534
FACILITY_NAME
INDEPENDENCE DAY CELEBRATION
STREET_NUMBER
0
STREET_NAME
CENTRAL PARK
City
MOUNTAIN HOUSE
Zip
95391
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\ymoreno
Supplemental fields
Site Address
CENTRAL PARK MOUNTAIN HOUSE 95391
Tags
EHD - Public
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Cu Ong Board <br />Propane Stove <br />Health Permit Sterna w/Challing <br />Dish <br />h4l,nch and Walar Garbage <br />Can <br />r <br />ice Cooler 5 Gal Hanoi WaSh <br />Wastewater Container <br />/i <br />aka ice Begs <br />sieved 6 Inches oil of the ground.? <br />5,20 Gal. <br />Hand wash Waler <br />Soap dispenser <br />Paper Hand Towels <br />Sanilizer bucket- <br />bleach &water for <br />sioring wipinm cloths <br />Propane Tank <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp, <br />DocuSign Envelope ID: A6E74685-DEDE-4900-90F6-8D6DC4F9DF9A <br />R EC-008 <br />SAN JOAOUIN <br /> <br />Environmental Health Department <br />C•UNTY--- <br />Greatnet;5 grows here.. <br />10. <br /> <br /> I am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br />5°F (II food is used the followin <br />Other (specify) <br /> <br /> <br />Refrigerator <br />efrigerated truck Ice bath and tubs <br />maintain below 41°F temperature): <br />lce chests <br />OR <br />11.providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />rrhree compartment sink. <br />4t <br />hree deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one ior a bleach <br />>< <br />ion (one tablespoon of bleach per gallon of water). <br />etergent, bleach, and wiping cloths (cleaning 1owels). <br />ub to store wiping cloths in bleach solution. <br />12. I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />• <br />booth: <br />Nater supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />/1-71)ne separate lub (bucket or basin) for the collection of rinse/wastewater. <br />Raper towels and pump-style soap container. <br />Npes of responsible persons to be presentythouth during all hours of ppergtion: <br />r-orlY>c C' mcilk C.s.A'D cr <br />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 operali R lum original to festival coordinator 'three weeks prior to <br />this event <br />Completed by: <br />1868 E. Hazelton Avenue I Stockton, California 95205 [ T 209 468-3420 I F 209 464-0138 I www.sjgov.org/ehd <br />El-ID 16-02 Page8of 11 TEMP EVENT APP <br />06/19/19 <br />OR <br />*important** <br />3wrec <br />Title <br /> <br />SUBMIT <br />Date <br />
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