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COMPLIANCE INFO
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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CENTRAL PARK
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1600 - Food Program
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PR0541099
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COMPLIANCE INFO
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Entry Properties
Last modified
9/9/2026 11:34:54 AM
Creation date
9/9/2026 11:28:47 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0541099
PE
1695 - TEMPORARY EVENT
FACILITY_ID
FA0023534
FACILITY_NAME
INDEPENDENCE DAY CELEBRATION
STREET_NUMBER
0
STREET_NAME
CENTRAL PARK
City
MOUNTAIN HOUSE
Zip
95391
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\jcastaneda
Supplemental fields
Site Address
CENTRAL PARK MOUNTAIN HOUSE 95391
Tags
EHD - Public
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10. <br />I am providing the following items within my booth for warewashing:11. <br />CPthrco compartment sink. <br />OR <br />14. <br />“Important** <br />Completed by: 15. <br />Si< <br />I Health Permit <br />Piipnf Hand rotvds <br />Sohfl (fcpVfUUl <br />Piopjno fitwu <br />P(IJfXM»U TlMlk <br />Dlviuii itfKl WblWScap and Water <br />Firo FxllnotrishN <br />■ <br />J <br />TUMP EVENT ATTPario fl ol 11 <br />.-..A <br />f <br />i <br />? <br />i <br />CUD Hi-02 <br />7/1-1/15 <br />I am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br />45T (if food is used the following day, maintain below 41°F temperature): <br />5-20 Go' <br />Hurd wash W.tlm <br />Gai bag e <br />Can <br />Sunilizor buchrt- <br />bloach & walor for <br />sIcNirwj wiping dotlis <br />Booth riiusl be on <br /> Concrete, Asphalt. <br />Plywood, or a Tarp. <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 waler). <br />5 Gul Hand tYHsh <br />V/u>lu*.valtir Conlahw <br />Sterna <br />Dish <br />Title Date <br />Names of responsible persons ^tobe Pr|^nt in hoot.!lduring all hours of operation: <br /> Ice chests Refrigerator <br /> Refrigerated truck Ice bath and tubs <br />I Al Other (specify) <br />l-xln ko Digs A Food Cantoiners must to <br />stvivtf 6 Inches all d Ibo ground' <br />/ <br />iaturo <br />12. I am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br />□detergent, bleach, wiping cloths (cleaning towels), and a tub to store wiping cloths in bleach solution. <br />fl <br />Ice Cooler <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 operation. Return original to festival coordinator throo weeks prior to <br />this event! / / \ <br />13. I am providing the following for adequate hand washing facilities, but separate from utensil wash within my booth: <br />Q^VVater 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/waslewater. Paper towels and a puiTifizStylCLSoaa <br />container. <br />Culling Board <br />lllcach
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