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COMPLIANCE INFO
Environmental Health - Public
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1600 - Food Program
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PR0541020
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COMPLIANCE INFO
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Last modified
7/8/2020 11:52:46 AM
Creation date
7/8/2020 11:48:04 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0541020
PE
1695
FACILITY_ID
FA0023482
FACILITY_NAME
RESTAURANT ON WHEELS
STREET_NUMBER
25
STREET_NAME
MAIN
STREET_TYPE
ST
City
MOUNTAIN HOUSE
Zip
95391
CURRENT_STATUS
01
SITE_LOCATION
25 MAIN ST
QC Status
Approved
Scanner
JCastaneda
Tags
EHD - Public
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I <br /> 10. 1 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 /> ❑Ice chestsefrigerator <br /> ❑ Refrigerated truck ❑ Ice bath and tubs <br /> ❑Other(specify) <br /> 11. 1 am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br /> '(9'Three compartment sink. <br /> OR <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 /> ❑Detergent, bleach,and wiping cloths(cleaning towels). <br /> ❑Tub to store wiping cloths in bleach solution. <br /> 12. 1 am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br /> booth: <br /> U'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 /> 13. Names o responsible persor�o be present in bootp during all hours of operation: <br /> �fL;T-Gt`�►�J <br /> , <br /> i <br /> "Important"" 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 three weeks prior to j <br /> this event. i <br /> 14. Completed by: VD \ L)tyNE7Z-- �,D-d t ! Cl i <br /> Signature Title Date j <br /> :.. .,...,:. 5.20 Gat I <br /> Health Permit Hand wash Wata J <br /> Sterno wlChapir'.g { <br /> Msh Paper Hand Tavels <br /> Scan duprnsn 1 <br /> I <br /> Cu:llnp 9oaN Sanllver buckel- <br /> bleadh a water for 1 <br /> o!eap sionng wiping c101115 i <br /> Propane Slave ? <br /> Booth must be on <br /> Concrete,Asphalt. <br /> Plywood,or a Tarp. <br /> Pr W enu 7anh <br /> Soap u[to Waters Rinse Wa,er Blench and Water I Garbage 1 <br /> Can <br /> Fue E>,tirqul5her <br /> Fxlra <br /> Wafer <br /> Ice Cooler 11Ca114end wa 9, <br /> E+Ira Ice[3ags 6 Fcul Containers mus[6e Waslaxalar Container <br /> stomcf 6 inches od W we ground( <br /> j <br /> i <br />
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