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COMPLIANCE INFO
Environmental Health - Public
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EHD Program Facility Records by Street Name
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RICHARDS
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1100
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1600 - Food Program
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PR0542315
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COMPLIANCE INFO
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Entry Properties
Last modified
9/12/2023 3:51:11 PM
Creation date
9/12/2023 3:50:49 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0542315
PE
1635
FACILITY_ID
FA0024301
FACILITY_NAME
ASH AND OIL #4NZ1494
STREET_NUMBER
1100
STREET_NAME
RICHARDS
STREET_TYPE
BLVD
City
SACRAMENTO
Zip
95811
CURRENT_STATUS
01
SITE_LOCATION
1100 RICHARDS BLVD
P_LOCATION
98
QC Status
Approved
Scanner
SJGOV\ymoreno
Tags
EHD - Public
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DocuSign Envelope ID: 06C1EA30-9D56-41F7-A40A-5AC05129E5EE <br />MFF MENU AND FOOD PREPARATION QUESTIONNAIRE <br />(Required to be completed for all new permit or renewal of permit applicants) <br />LOADED WONTON CHIPS (CHICKEN/STEAK/TOFU), LOADED HOT DOG, Menu Items: <br />HOT DOG, ASIAN SLAW, WONTON CHIPS, BOTTLED WATER, CANNED SODA <br />Cooking equipment used on the truck: GRILL, DEEP FRYER, STEAM TABLE <br />ONLY ON TRUCK Cooking equipment used at the commissary: <br />ON TRUCK Where are the food items prepared/cooked: <br />ON TRUCK Where are the food ingredients/supplies stored: <br />Comments: <br />e.--DocuSigned by: <br />/uua ttliOra, <br /> <br />3/22/2023 <br />L-7C84EFA20F6A4B1 <br />Signature of MFF Owner <br /> <br />Date <br />Inspector Signature Date <br />OnIASH•P RWIRAMS & PROJECTSAIrr AND TI7 WORKING FOL DERSINIFFeNIFF FORMS & HANDOUTS LIPDATEDYWORD DOCS.OPERATOR • COMMISSARY VERIFICATION 12 21 I RA.:
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