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COMPLIANCE INFO
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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D
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DE VRIES
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12145
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1600 - Food Program
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PR0526555
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COMPLIANCE INFO
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Entry Properties
Last modified
7/12/2026 10:56:27 AM
Creation date
7/12/2026 10:49:41 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0526555
PE
1695 - TEMPORARY EVENT
FACILITY_ID
FA0017972
FACILITY_NAME
KINGDON DRAGS
STREET_NUMBER
12145
Direction
N
STREET_NAME
DE VRIES
STREET_TYPE
RD
City
LODI
Zip
95242
APN
05518005
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\jcastaneda
Supplemental fields
Site Address
12145 N DE VRIES RD LODI 95242
Tags
EHD - Public
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8. <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensils:9. <br />□ Three compartment sink. <br />OR <br />□ Detergent blead' and wining dofos 'cleaning towe*s' <br />10. <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 />Names of responsible persons to be present in booth during all hours of operation:13. <br />"Important" <br />Completi14. <br />Signature Title <br />Health Permit <br />~l Paper Hand Towets <br />1[ <br />BleachPropane Stove <br />1 <br />rinse 7.atc- <br />Ftre EUmcuishar <br />Ice Cooler <br />Page 8 of 11 TEMP EVENT APP <br />5 Gal Handwash <br />WasOnKBer Contaner <br />EHD 16-02 <br />10/13/09 <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 />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 />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 opytitioh Return original to festival coordinator three weeks prior to <br />this event J <br />StemowlChaffing <br />Otsh <br />□ Refrigerator <br />□ Ice bath and tubs <br />5 20 G* <br />Hand wa-h V.'83M <br />Garbage <br />Can <br />□ ice chests <br />□ Refrigerated truck <br />□ Other (specify) <br />Extra ix Bags & Food must be <br />stored 6 inches off ot tbegmundt <br />Santowbutet- <br />bteochA wafer tar <br />storing doths <br />I am providing the folowing for adequate hand washing facTfies, but separate from utensil wash within my <br />booth: <br />Booth must be on <br />Concrete, Asphat. <br />Phnwood or a ’arr- <br />I Seep and Water I i <br />I Soap dspenser <br />I Propene Ta* I <br />CuErg Basta I
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