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COMPLIANCE INFO 2017-PRESENT
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1600 - Food Program
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PR0542351
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COMPLIANCE INFO 2017-PRESENT
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Entry Properties
Last modified
12/13/2018 11:43:00 AM
Creation date
12/7/2018 9:45:50 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2017-PRESENT
RECORD_ID
PR0542351
PE
1608
FACILITY_ID
FA0024330
FACILITY_NAME
JAHNELLE'S POP SHOP
STREET_NUMBER
1483
STREET_NAME
BRIDGEPORT
STREET_TYPE
LN
City
MANTECA
Zip
95336
CURRENT_STATUS
01
SITE_LOCATION
1483 BRIDGEPORT LN
P_LOCATION
04
QC Status
Approved
Scanner
WNg
Supplemental fields
FilePath
\MIGRATIONS\B\BRIDGEPORT\1483\COMPLIANCE INFO 2017-PRESENT.PDF
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EHD - Public
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❑ Dried or Dehydrated ❑ Dried Vegetarian- E] Vegetable and Potato Chips <br /> Vegetables Based Soup Mixes <br /> ❑ Sweet Sorghum ❑ Roasted Coffee Chocolate Covered Nonperishable Food <br /> Syrup (Beans/Grounds) <br /> ❑ Fried or Baked ❑ Dried Hot Chocolate ❑ Fruit Infused Balsamic Vinegar <br /> Donuts and Waffles <br /> ❑ Other <br /> Do not contain eggs,cream,or cream cheese <br /> "*If preparing jams,jellies or fruit butters, include a list of ingredients(attach separate page if needed). These items <br /> must comply with standards described in Part 150 of Title 21 of the Code of Federal Regulations <br /> http//www accessdata fda gov/scripts/cdrh/cfdocs/cfCFR/CFRSearch cfmvCFRPart=150 <br /> Food Descriptions: <br /> p��� f'�►prp manshag,� "'s Kri plp J 1-a <br /> A A 4- L&T <br /> EHD 16-277/27/17 2 CFO REG/PERMITTING FORM <br />
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