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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 />9. <br />OR <br />irgent, bleach, and wiping cloths (cleaning towels). <br />ub to store wiping cloths in bleach solution. <br />10. <br />13. <br />"Important** <br />14.Completed by: <br />Health Permit <br />P«P«r Hanfl Toweis <br />Cutting Boanl <br />Propane Stove Bloach <br />Propane Tank <br />Rinse Water <br />Ice Cooler '1 j <br />Page 8 of 11 TEMP EVENT APP <br />EHD 16-02 <br />10/13/09 <br /> Refrigerator <br /> Ice bath and tubs <br />5Ga' Hancwajn <br />Wastewater Contaner <br />Booth must be on <br />Concrete, Asphalt. <br />Plywood, ora Tarp <br />H Ice chests <br /> Refrigerated truck <br /> Other (specify) <br />Garbage <br />Can <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br /> Three compartment sink. <br />Slemo wChaffing <br />Dtti <br />Sanitiz»rbuck®t- Moach & waiter lot <br />Monng Mpmg dotha <br />H Water supply dispenser with warm water at a minimum of 100’F (i.e. 5-20 gallon container with spigot) <br />[0^ne separate tub (bucket or basin) for the collection of rinse/wastewater <br />IZ'Paper towels and pump-style soap container <br />• <br />Extra tea Bags & Food Combiners must be H <br />stored 6 inches off of theground1 K <br />Date <br /> I <br /> <br />| Scap and Water | f <br />Hre extinguienar <br />5-20 Gal. <br />r- Hanfl wast Water <br />| Soap dispenser | \ <br />for wa,er'one for rinsing and one tor •bieacfi <br />of responsible persons to be present in booth during all hours of operation <br />All foot) vendor booths are subject to inspection. Please make a'copyof this application in ' <br />prepajatipn for this event. A copy of this checklist must be in the booth at all hours of <br />*h< fa J °Perat*0P? Return original to festival coordinator three weeks prior to <br />Jr Sigifeure / <br />' ^Vid^S ,he_!ol^rl9 “Id 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 />j | Bleach and Witar j <br />Q f <br />^arr^providmg the following for adequate hand washing facilities, but separate from utensil wash within my <br />Title
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