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COMPLIANCE INFO
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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E
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EATON
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198
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1600 - Food Program
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PR0541211
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COMPLIANCE INFO
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Entry Properties
Last modified
7/5/2026 10:27:27 AM
Creation date
7/5/2026 10:26:14 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0541211
PE
1695 - TEMPORARY EVENT
FACILITY_ID
FA0023607
FACILITY_NAME
1ST ANNUAL TRACY INTERTRIBAL POW WOW
STREET_NUMBER
198
Direction
E
STREET_NAME
EATON
STREET_TYPE
AVE
City
TRACY
Zip
95376
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\bmascaro
Supplemental fields
Site Address
198 E EATON AVE TRACY 95376
Tags
EHD - Public
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10. ‘ <br />I am providing the following items within my booth for warewashing:11. <br /> Three compartment sink. <br />OR <br />12. <br /> Detergent, bleach, wiping cloths (cleaning towels), and a tub to store wiping cloths in bleach solution. <br />providing the following for adequate hand washing facilities, but separate from utensil wash within my booth:13. lam <br />14. <br />Completed by:, 15. <br />Signature <br />Health Permit <br />Paper Hand Towels <br />Soap dispenser <br />Cutting Board <br />Bleach <br />Propane Stove <br />Propane Tank <br />J <br />Bleach and WaterRinse Water <br />Fire Extinguisher <br />Ice Cooler <br />TEMP EVENT APPPage 8 of 11EHD 16-02 <br />Q 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 />All food vendor booths are subject to inspection. Please make a copy of this application in <br />preparation for this event. , <br />preparati9A-gi . ' <br />this evi <br />Stemo w/Chaffing <br />Dish <br /> Refrigerator <br /> Ice bath and tubs <br /> <br />Garbage <br />Can <br />Booth must be on <br /> Concrete, Asphalt, <br />Plywood, or a Tarp. <br />5 Gal Hand wash <br />Wastewater Container <br />5-20 Gal. <br />Hand wash Water <br />Sanitizer bucket <br />bleach & water for <br />storing wiping cloths <br />Extra <br />Water <br />3 y>\l^v <br />DateTitle <br />jjMce chests <br /> Refrigerated truck <br /> Other (specify) <br />**lmportant** <br />Extra Ice Bags & Food Containers must be <br />stored 6 inches off of the ground! <br />•_ A copy of this checklist must be in the booth at all hours of <br />md operation. Return original to festival coordinator three weeks prior to <br />it/ <br />I am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br />45°F (if food is used the following day, maintain below 41 °F temperature): <br />Names of responsible persons to be present in booth during all hours of operation. <br /><TXc4n zIfa S ______________________ ___________— <br /> Water supply dispenser with warm water at a minimum of 100°F (i.e. 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 <br />container. <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensils. <br /> . ..y,. yL.. - - <br />Soap and Water
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