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COMPLIANCE INFO_2026
Environmental Health - Public
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1600 - Food Program
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PR0541099
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COMPLIANCE INFO_2026
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Entry Properties
Last modified
7/22/2026 2:28:03 PM
Creation date
7/16/2026 3:59:44 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2026
RECORD_ID
PR0541099
PE
1695 - TEMPORARY EVENT
FACILITY_ID
FA0023534
FACILITY_NAME
INDEPENDENCE DAY CELEBRATION
STREET_NUMBER
0
STREET_NAME
CENTRAL PARK
City
MOUNTAIN HOUSE
Zip
95391
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\ymoreno
Supplemental fields
Site Address
CENTRAL PARK MOUNTAIN HOUSE 95391
Tags
EHD - Public
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REC-008 <br />Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br />Q-Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />□ One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />□ Paper towels and pump-style soap container. <br />13. <br />“Important** <br />this event.Co-Owner 06-05-2026 <br />14.Completed by: <br />DateTitle <br />I <br />Paper Hand Towels <br />Soap dispenser <br />Cuttinp Board <br />■1 i <br />BleachPropane Stove <br />Rinse Waler Bleach and Water <br />Fre Extinguisherfl <br />Ice Cooler <br />□ Three deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br />solution (one tablespoon of bleach per gallon of water). <br />□ Detergent, bleach, and wiping cloths (cleaning towels). <br />□ Tub to store wiping cloths in bleach solution. <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />Q Three compartment sink. <br />Extra Ice Bags & Food Containers must be <br />stored 6 inches oH ol the ground! <br />Sterno w Chaffing <br />Dish <br />Extra <br />Water <br />5 Gal Hand wash <br />Wastewater Container <br />Garbage <br />Can <br />Sanitizer bucket <br />bleach & waler lor <br />storing wping doths <br />Booth must be on <br />Concrete. Asphalt. <br />Plywood, ora Tarp. <br />5-20 Gal. <br />Hand wash Waler <br />_z <br />Soap and Water <br />Propane Tank <br />SAN JOAOUIN <br />------COUNTY------ <br />lcoPZf Greatness grows here. <br />I am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br />45°F (if food is used the following day, maintain below 41 °F temperature): <br />Q Ice chests Q Refrigerator <br />□ Refrigerated truck Q Ice bath and tubs <br />Q Other (sPecifv)freezer________________________________________________________________ <br />| Health Permit <br />Names of responsible persons to be present in booth during all hours of operation: <br />Jill Ryan, Juan Macias, Sophia Macias <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />EHD 16-02 Page 8 of 11 TEMP EVENT APP <br />06/19/19 <br />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 />•‘UQT^kl V« GovOS com <br />oiCjnaiui c
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