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COMPLIANCE INFO_2025
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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PEARSON
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11335
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1600 - Food Program
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PR0521340
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COMPLIANCE INFO_2025
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Entry Properties
Last modified
1/28/2026 8:28:23 AM
Creation date
1/22/2026 8:37:26 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2025
RECORD_ID
PR0521340
PE
1695 - TEMPORARY EVENT
FACILITY_ID
FA0012744
FACILITY_NAME
CAMBODIAN HOLIDAY
STREET_NUMBER
11335
STREET_NAME
PEARSON
STREET_TYPE
RD
City
LODI
Zip
95240
APN
05917014
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\ymoreno
Supplemental fields
Site Address
11335 PEARSON RD LODI 95240
Tags
EHD - Public
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` SANsJOAQUIN <br /> Environmental Heath Department <br /> 10. 1 am providing the following cola temperature control for the coil holding of ootervally hazardous foods below <br /> 45°F (if food is used the following day, maintain below 41°F temperature). <br /> ❑ Ice chests ❑ Refrigerator <br /> Elliefrigerated truck ❑ Ice bath and tubs <br /> ❑ Other(specify) <br /> 11. 1 am providing the following items within my booth for the sanitary cleaning of food preparation utensil <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 /> [g Detergent, bleach, and wiping cloths (cleaning towels). <br /> ❑ Tub to store wiping cloths in bleach solution. <br /> 12, 1 am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br /> booth: <br /> ❑Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br /> ❑ One separate tub (bucket or basin) for the collection of rinse/wastewater. <br /> Paper towels and pump-style soap container. <br /> 13. Names of responsible persons to be present in booth during all hours of operation: <br /> �_ �.�� <br /> "''Important' Al food v� r booths are subject to inspection. Please make a copy o this application in <br /> preparation for this event. A copy of this checklist must be in the booth at ail hours of <br /> preparation and operation. Return original to festival coordinator three weeks prior to <br /> this event. <br /> 14. Completed by: <br /> nature Title Date <br /> sac 3aj <br /> Health Permit Hans wash water <br /> Stereo wrCeafhnS <br /> 0 5n <br /> Paper Hand Tt7wBi6 <br /> soar,o-so-enser <br /> Cutnt+g Board Sanifter bucket, <br /> bieacr d water ter <br /> caane Stave B-eacl sEonng wipng Goths <br /> Booth must be on <br /> Concrete,Asphalt. <br /> Plywood.or a Tarp <br /> soap arc:water Rmse water 9Iaacr antl Wafer Garbage <br /> Can <br /> Water <br /> f1ce Cooler t. 5 3al Hanr w.s^ <br /> E,ira rce bags d -- Nastewater Container <br /> —---— vvec 6,rcnes aX c:.,e y.. <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 F 209 464-0138 1 www,sigov.org/ehd <br /> F"r -Ail.; Page 8 of 11 TEMP EVENT APP <br />
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