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COMPLIANCE INFO_2024
Environmental Health - Public
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1600 - Food Program
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PR0535497
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COMPLIANCE INFO_2024
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Entry Properties
Last modified
4/9/2026 3:18:36 PM
Creation date
6/2/2025 2:54:38 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2024
RECORD_ID
PR0535497
PE
1695 - TEMPORARY EVENT
FACILITY_ID
FA0020469
FACILITY_NAME
MUSIC IN THE PARK
STREET_NUMBER
25
Direction
E
STREET_NAME
MAIN
STREET_TYPE
ST
City
MOUNTAIN HOUSE
Zip
95391
APN
20905010
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\ymoreno
Supplemental fields
Site Address
25 E MAIN ST MOUNTAIN HOUSE 95391
Tags
EHD - Public
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R CC-003 <br /> • �ur6V <br /> S AN d 0 A Q L I N Environmental Health Department <br /> I I <br /> C*UNTY— <br /> TEMPORARY FOOD VENDOR'S APPLICATION <br /> All lood vendors (both for profit and non-profit) are required to return a signed and completed copy of this cheoWlst to <br /> the festival coordinator three($) weeks prior to this event: <br /> Musl41111110 F'sr,., Kite Festival Juneteenth July 4 July 20 5/18,6,,/1,6/15,7/4,7/20 <br /> 1. 1.Nam4 of Event: Dato(s) <br /> 2. The following is information about my organ Izalion/business: <br /> Name of organ laallon/buslness: Shl,�h Grill <br /> Address: 1061 Market Place San Ramon CA f <br /> i <br /> Phone: +1 (925)-415-3270_ -- Alternate: <br /> 3, t-ist food to bo sold or given to the public: ,Chicken Shawarma wrap, Falafel,fro, Fries, &Lamb Surger � <br /> . � 1 <br /> 4. 1 am providing food that Is NOT prepared at home:M1,000 <br /> All food Is prepared on-silo or is from approved commercial facfHtles:21Ysz:1€o <br /> Name of facility: Shish GrIll Phone: <br /> Address of lacllily 1Qarket Place San Damon CA <br /> 6. 1 am providing a booth with the lollowing: (to protect my unpaolcaged food and food-proparalIon areas from files, <br /> dust and the public) <br /> ✓ booth with walls and oelling constructed of 0her wood, canvas, plastic, sir rillar material and f Ine mesh fly <br /> '- ening, completely enclosing: open food areas, It will also have a smooth and cleanable floor (concrete, <br /> asphalt, dean carps and smooth wood are acceptable) and constructed to separate lood and food preparation i <br /> aroas from the public. <br /> �1her(speolly): <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 /> 3 <br /> 8, Approved water for drinking, utensil and hand washing wlil be provided In my booth by the following molhods: <br /> [✓Approver! bottled water. <br /> �n-site hose bib that Is connected to a potable water source. <br /> Pther(speolly): <br /> 7. rlclly is provided for my booth's use Ye r/No <br /> 8, 1 am providing an accurate probe the r asuro the hol and cold holding of potentially hazardous <br /> foods during all times of booth operallon �/ Ye o <br /> 9, 1 am providing the following hot temperalu oOr o the hot holding of all potentially hazardous foods above <br /> aarrlp stove ✓Sterno& hotel trays <br /> ouble steamer Stearn table &Ilds <br /> lectric stove top QIher(specify) <br /> Note_ Examples of polentially hazardous food include: mt�, its, tamales, cooked beans, rice, ) <br /> vegetables,potato salad,eggs,and dairy products. <br /> i <br /> 1068 E.1-fazelton Avenue I Stockton,Calif ornla 05205 I T 209 468-3420 I F 209 464-0138 I www,sjgov,org/ehd <br /> CHO 16.02 Pnon 7nf 1 r TRAP FVCNTAPP <br /> Ufi/tUl1g <br /> I <br />
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