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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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1 <br />NAME OF FOOD BOOTH: <br />z <br />3. <br />4. <br />5. <br />OFFICIAL USE ONLY <br />i List all food and beverage <br />f items (e.g., tacos, tortillas, <br />shredded chicken, salsa, <br />1 lemonade, etc.). <br />How will food be prepared <br />(e.g., BBQ, deep-fry, grill, <br />etc.)? <br />What type of insulated <br />container will be used to <br />transport potentially <br />hazardous foods to keep <br />them above 135°F or below <br />41°F? <br />TFF MENU SHEET <br />3 <br />Gq£..Y .. <br />L <br />DOC TYPE: CORRESPONDENCE <br />Type of food holding units in <br />booth (e.g., ice chest, <br />freezer, chafing dishes, <br />crock pot, etc.). Note: Use <br />of BBQ grill to hold food <br />is strictly prohibited. <br />1 ■ JSVfa Q n -t-CC <br />If food is prepared off site, <br />give the location name, <br />address, & phone number <br />of place (foods may not be <br />stored or prepared at <br />home). <br />n _ <br />_L I II—■■ ■—TTH ■ — ■ ■ <br />How will the food be j <br />handled and dispensed9 I <br />(tongs, ladle, etc.) J
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