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EnvironmentalHealth
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EHD Program Facility Records by Street Name
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RUTLEDGE
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1127
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1600 - Food Program
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PR0544073
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COMPLIANCE INFO
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Entry Properties
Last modified
1/30/2019 11:01:03 PM
Creation date
1/30/2019 2:32:22 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0544073
PE
1608
FACILITY_ID
FA0025069
FACILITY_NAME
SHELLY'S SUGAR SHAK
STREET_NUMBER
1127
STREET_NAME
RUTLEDGE
STREET_TYPE
WAY
City
STOCKTON
Zip
95207
CURRENT_STATUS
01
SITE_LOCATION
1127 RUTLEDGE WAY
P_LOCATION
01
QC Status
Approved
Scanner
JCastaneda
Tags
EHD - Public
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SA N J O A Q I I I N Environmental Health Department <br /> COUNTY- I, <br /> 9. Employee: Initial if you agree to abide by the following: <br /> I understand that I may not have more than one full-time equivalent cottage food employee, not including a <br /> family member or household member of the cottage food operator, working within the registered or permitted <br /> area of a private home where the cottage food operator resides and where cottage food products are prepared <br /> or packaged for direct, indirect, or direct and indirect sale to consumers. <br /> 10. Delivery Limitation: Initial if you agree to abide by the following: <br /> I understand that I may accept orders and payments via the internet, mail or phone. However, all "Class A" and <br /> "Class B" CFO products must be delivered directly(in person)to the customer. The CFO products may not be <br /> delivered via the United States Postal Service, UPS, FedEx, or using any other indirect delivery method as <br /> deliveries are regulated by, and subject to, CDPH registration and state and federal requirements. <br /> 11. Owner's Statement: <br /> I, J Imo- 6,1agree to grant access to the local health department to <br /> conduct an ins tion of my cotta a food operation (mark one) <br /> "Class A": In the event of a consumer ❑ "Class B": For regular annual facility <br /> complaint or reported food-borne illness inspections and in the event of a consumer <br /> complaint or food-borne <br /> agree to notify the San Joaquin County <br /> Environment ealth Departme prior to modifying my food list, type of operation, and/or method of <br /> selling, distributing, or otherwise providing my CFO products to the consumer or retailers, regardless of <br /> whether the product sold nsigned, or given away. <br /> Q- l <br /> OJv is Si nat re Print Na Date <br /> 5 of 5 <br /> EHD 16-27 6/29/17 CFO REG/PERMITTING FORM <br />
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