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COMPLIANCE INFO
Environmental Health - Public
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EHD Program Facility Records by Street Name
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1600 - Food Program
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PR0535497
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COMPLIANCE INFO
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Entry Properties
Last modified
6/8/2026 11:55:10 AM
Creation date
6/8/2026 11:50:49 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0535497
PE
1695 - TEMPORARY EVENT
FACILITY_ID
FA0020469
FACILITY_NAME
JUNETEENTH CELEBRATION
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\tchampion
Supplemental fields
Site Address
25 E MAIN ST MOUNTAIN HOUSE 95391
Tags
EHD - Public
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2 0 0& <br />1 <br />I <br />by the due date above . <br />Date <br />Da1itative <br />I <br />i <br />Mountain House Community Event <br />Food Vendor <br />Contact Angel Lamb at (209) 831-5651 <br />Staff Only <br />Check <br />^Temporary Food Application <br /> Health Permit <br />Business Insurance <br />Food Vendor Agreement Form <br />Contactd.d <br />Phone#! <br />------------ ----------------- MHCSP will provide: <br />10X10 space to sell to the public at the Mountain House event specified above. <br />dH^A y^anK you fcj y°y support. <br />MHCSD Representative <br />***** NOTE: MHCSD must receive rnib biyiicu ------------- <br />amount of $50.00 3 weeks before the event <br />will not be accepted. The fee must be paid in advance —Late applications and agreements will not oe accep _j---------- <br />Vendor: "Q ? <br />Email: Phone/ <br />Address:\~Vc\k^ cA TblSCcA fax# <br />Description of Food to Seirp <br /> | Food Vendor will provide: J <br />Service to sell to public at the <br />(specify event you are participating in) <br />This event will take place at Central Community Park, 25 E. Main Street, Mountain <br />House, CA 95391. <br />The vendor will provide its setup in compliance with Health Department recrements and <br />ensure that the setup is secure due to the potential for^strong wmd tn ^°un^ouse- <br />no early tear-downs allowed without on-site staffs permission. <br />: MHCSD must receive this signed Vendor Agreement and a check in the <br />ndor R<
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