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COMPLIANCE INFO_2024
EnvironmentalHealth
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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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Paper Hand Towels <br />Sanatzer bucket- <br />bleach &water or <br />WringWpfl clot's <br />Boolh must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />DocuSign Envelope ID: A6E74685-DEDE-4900-90F6-8D6DC4F9DF9A <br />REC-008 <br />SAN JOAQUIN Environmental Health Department <br />4Ic10 <br /> <br /> I am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br />5"F (if food is used the followin_day, maintain below 41°F temperature): <br />e chests Refrigerator <br />efrigerated truck Ice bath and tubs <br />!her (sPeeify)_n/a prepackagedlood___. _ <br />providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />rihree 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 />ion (one tablespoon of bleach per gallon of water). <br /> Detergent, bleach, and wiping cloths (cleaning towels). Ai /ft eye iocgotlae.c f <br />Rub to store wiping cloths in bleach solution. <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />ENater supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />Tk ne separate tub (bucket or basin) for the collection of rinse/wastewater. _ pre pAc_C-k•CtICC( <br />F1'aper towels and pump-stvle soap container. Fucd <br />13. Names of responsible persons to be present in booth during all hours of operation: <br />krystle wright <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 e nt. <br /> <br /> Own-e( cot t; 114 SUBMIT <br /> <br />Title Date <br />Health Permit <br />Sterne WChalltng <br />Our <br />Soap &sponse( <br />Colton) Board <br />Propane Stove <br />Garbage <br />Can <br />Completed by: <br />n'arrrt <br />5-20 Gal <br />Hand wasp Water <br />Ice Cooler <br />Extra Ice Bags Ai Food Containers must he <br />stored 6 onches 06 01 The ground, <br />5 Gal Hand wash <br />Wastewater Cent ehner <br />1868 E. Hazellon Avenue I Stockton, California 952051 T 209 468-3420 I F 209 464-0138 1 www.sjgov.org ehd <br />ENO 16-02 Page 8 of 11 TEMP EVENT APP <br />0&'19:19
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