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COMPLIANCE INFO_PRE 2019
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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1600 - Food Program
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PR0543861
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COMPLIANCE INFO_PRE 2019
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Entry Properties
Last modified
6/14/2026 12:44:40 PM
Creation date
6/14/2026 12:43:28 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
PRE 2019
RECORD_ID
PR0543861
PE
1695 - TEMPORARY EVENT
FACILITY_ID
FA0024939
FACILITY_NAME
COUNTRY CLUB BLVD FALL STREET FAIR
STREET_NUMBER
0
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\bmascaro
Supplemental fields
Site Address
COUNTRY CLUB BLVD STOCKTON 95204
Tags
EHD - Public
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Environmental Health Department <br />TEMPORARY EVENT FOOD VENDOR LIST <br />NAME OF BOOTH <br />/< / /V <s> <br />mUAaCV <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjcehd.com <br />EHD 16-02 Page 11 of 11 TEMP EVENT APP <br />1 > yvTeLC? <br />FV#- Corresponding number for Food Booth on site plan <br />NAME OF BOOTH-Food vending business <br />CONTACT PERSON-Responsible person for booth <br />PHONE #-Phone number of Contact <br />FV# <br />person before and on day of event <br />CONTACT PERSON <br />i'4~T CJri'/ <br />(2! N TAKQ. <br />AA / Q <br />Msp/ppyz Mexico <br />J T <br />PpC/ C€./f <br />■ <br />PHONE# <br />k ____________ __________________ <br />no-3 <br />3-^0^ 7 <br />SANJOAOUIN <br />._ ------COUNTY------- <br />\ / <br />•e5t,FO<i^'-T/ Greatness grows here.
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