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COMPLIANCE INFO_2024
Environmental Health - Public
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EHD Program Facility Records by Street Name
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L
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LOCKEFORD
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413
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1600 - Food Program
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PR0548807
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COMPLIANCE INFO_2024
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Entry Properties
Last modified
3/28/2025 10:54:39 AM
Creation date
3/28/2025 10:53:32 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2024
RECORD_ID
PR0548807
PE
1695 - TEMPORARY EVENT
FACILITY_ID
FA0027956
FACILITY_NAME
RALLY IN THE VALLEY
STREET_NUMBER
413
Direction
E
STREET_NAME
LOCKEFORD
STREET_TYPE
ST
City
LODI
Zip
95240
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\ymoreno
Supplemental fields
Site Address
413 E LOCKEFORD ST LODI 95240
Tags
EHD - Public
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SAN,JOAQUIN Environmental Health Department <br />TEMPORARY FOOD VENDOR'S APPLICATION <br />All food vendors (both for profit and non-profit) are required to return a signed and completed copy of this checklist to <br />the festival coordinator three (3) weeks prior to this event. <br />1. Name of Event: yvi "Me Date(s): <br />The following is information about my organization/business: <br />Name of organization/business: fuele'e's Alt;41. Pvieiles <br /> <br />Address: 'Ared.c/i/im 0,6/ 54volot17l 4 95-02i0 <br />Phone: (91,01) 1f'5--7't'3 <br /> <br />Alternate: ( <br /> <br />List food to be sold or given to the public: Mtn, pame, et be g,rtal ieee92,1-, <br />I am providing food that is NOT prepared at hom Yes E No <br />All food is prepared on-site prs is from approved commercial facilities: Yes I=1 No <br />res-i-tw-a phone: (-7-et gb.q-77/ <br />g/ 3 LociteCtn--d (ri- Lodi q5--a.ci <br />I am providing a booth with the following: (to protect my unpackaged food and food-preparation areas from flies, <br />dust and the public) <br />booth with walls and ceiling constructed of either wood, canvas, plastic, similar material and fine mesh fly <br />screening, completely enclosing open food areas. It will also have a smooth and cleanable floor (concrete, <br />asphalt, clean tarps and smooth wood are acceptable) and constructed to separate food and food preparation <br />areas from the public. <br />['Other (specify) <br />Note: The only operations not required to provide enclosed booths are those which sell beverages from <br />approved dispensers, or prepackaged foods from approved sources. <br />6. Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: <br />,12 i.(pproved bottled water. <br />El On-site hose bib that is connected to a potable water source. <br />LI Other (specify): <br />Electricity is provided for my booth's use: es E No <br />I am providing an accurate probe thermom_e_test6 measure the hot and cold holding of potentially hazardous <br />foods during all times of booth operationi Yes E No <br />I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br />135°F: 0 Camp stove E Sterno & hotel trays <br />I=1 steamer / uble 6 ['Steam table & lids <br />Electric stove top her (specify) <br />Note: Examples of potentially hazardous food include: meats, tamales, cooked beans, rice, <br />vegetables, potato salad, eggs, and dairy products. <br />1868 E Hazelton Avenue I Stockton. California 95205 I T 209 468-3420 I F 209 464-0138 I www.sjgov.org/ehd <br />EHD 16-02 Page 7 of 11 TEMP EVENT APP <br />06/29/2023 <br />Name of facility: <br />Address of facility:
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