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COMPLIANCE INFO_2023
Environmental Health - Public
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EHD Program Facility Records by Street Name
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RICHARDS
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1600 - Food Program
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PR0542315
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COMPLIANCE INFO_2023
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Entry Properties
Last modified
12/15/2023 3:09:50 PM
Creation date
10/18/2023 2:03:41 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2023
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
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SJGOV\lsauers1
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EHD - Public
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DocuSfgn Envelope ID:06C 1 EA30-9D56-41 F7-A40A-5AC05129E5EE <br /> MFF MENU AND FOOD PREPARATION QUESTIONNAIRE <br /> (Required to be completed for all new permit or renewal of permit applicants) <br /> Menu Items: LOADED WONTON CHIPS (CHICKEN/STEAK/TOFU), LOADED HOT DOG, <br /> HOT DOG, ASIAN SLAW, WONTON CHIPS, BOTTLED WATER, CANNED SODA <br /> Cooking equipment used on the truck: GRILL, DEEP FRYER, STEAM TABLE <br /> Cooking equipment used at the commissary: ONLY ON TRUCK <br /> Where are the food items prepared/cooked: ON TRUCK <br /> Where are the food ingredients/supplies stored: ON TRUCK <br /> Comments: <br /> Do uSigned by: <br /> iu, (,a� <br /> 3/22/2023 <br /> Ut.ln. ra <br /> Signature � <br /> of MFF Owner Date <br /> Inspector Signature Date <br /> w-:,M,,T-P-PR(KiRA\IS&PRUJEMINIFF AND Tr-MAKIRU FUIDERS,%1MINffF rURms&RANDUMS 1UPDATEDYKURD M'SAPERATUR-COMIUSSARY VOURCATWN 1111 19.d. <br /> 2 <br />
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