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COMPLIANCE INFO
Environmental Health - Public
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EHD Program Facility Records by Street Name
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T
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12 (STATE ROUTE 12)
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9009
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1600 - Food Program
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PR0540196
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COMPLIANCE INFO
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Entry Properties
Last modified
6/12/2026 10:56:10 AM
Creation date
6/12/2026 10:54:00 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0540196
PE
1695 - TEMPORARY EVENT
FACILITY_ID
FA0022982
FACILITY_NAME
CAJUN AND BLUES FESTIVAL
STREET_NUMBER
9009
Direction
W
STREET_NAME
STATE ROUTE 12
City
LODI
Zip
95242
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\tchampion
Supplemental fields
Site Address
9009 W STATE ROUTE 12 LODI 95242
Tags
EHD - Public
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10. <br />11. <br />OR <br />12. <br />13. <br />14. <br />15.Completed by: <br />Date *ignature <br />Health Permit <br />Paper Hand Towels <br />Soap dispenser <br />Culling Board <br />Propane Stove Bleach <br />Propane Tank <br />Soap and Waler Rinse Water Bleach and Water <br />Fire Extinguisher <br />Ice Cooler <br />Page 8 of 11 <br />TEMP EVENT APP <br />EHD 16-02 <br />7/14/15 <br />Sterno wfChaffing <br />Dish <br />5 Gal Hand wash <br />Wastewater Container <br />5-20 Gal <br />Hand wash Waler <br />Garbage <br />Can <br />Booth must be on <br />Concrete. Asphalt. <br />Plywood, ora Tarp. <br />Extra Ice Bags & Food Containers must be <br />stored 6 inches off of the ground1 <br />Extra <br />Water <br />Sanitizer bucket- <br />bleach & water for <br />slonng wiping doths <br />□ Refrigerator <br />□ Ice bath and tubs <br />Title <br />.1 <br />.0 <br />1 <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br />Detergent, bleach, wiping cloths (cleaning towels), and a tub to store wiping cloths in bleach solution. <br />1 am providing the following items within my booth for warewashing: <br />□ Three compartment sink. <br />,o, soapy *““■ °"s for a"da <br />□ Ice chests <br />□ Refrigerated truck <br />O Other (specify) <br />°f operation: <br />important- All food vendor booths are subject to inspection. Please make a copy of this application in <br />preparation for this event. A copy of this checklist must be in the booth at all hours of <br />preparation and operation Return original to festival coordinator three weeks prior to <br />«• •»• o v e 11 l . <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my booth:
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