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EHD Program Facility Records by Street Name
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1600 - Food Program
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PR0541418
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COMPLIANCE INFO
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Entry Properties
Last modified
5/21/2020 1:46:54 PM
Creation date
2/15/2019 1:17:02 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0541418
PE
1609
FACILITY_ID
FA0023734
FACILITY_NAME
TERRA COFFEE ROASTERS
STREET_NUMBER
3044
STREET_NAME
HORSETAIL
STREET_TYPE
DR
City
STOCKTON
Zip
95212
CURRENT_STATUS
01
SITE_LOCATION
3044 HORSETAIL DR
P_LOCATION
01
QC Status
Approved
Scanner
JCastaneda
Tags
EHD - Public
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0 ! 11 <br /> 9. Employee: Initial if you agree to abide by the following: r-6_1 <br /> I understand that I may not have more than one full-time equivalent cottage food employee, not <br /> including a family member or household member of the cottage food operator, working within the <br /> registered or permitted area of a private home where the cottage food operator resides and where <br /> cottage food products are prepared or packaged for direct, indirect, or direct and indirect sale to <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 <br /> A" and"Class B" CFO products must be delivered directly(in person) to the customer. The CFO products <br /> Indy nui ucr ueiivai Cu vie iiia iiniie i Sidies Pusidi SeIviva, iiFF-3, Feu-Ex, ui ubiny dliy u1mul inuiieui <br /> delivery method as deliveries are regulated by, and subject to, CDPH registration and state and federal <br /> requirements. <br /> 11. Ownneerr'a l') "1's Statement: <br /> I, C%` ` aC CA , agree to grant access to the local health <br /> department to conduct an inspection of my cottage 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 /> Environmental Health Department prior to modifying my food list, type of operation, and/or method <br /> of selling, distributing, or otherwise providing my CFO products to the consumer or retailers, <br /> regardless of whether the product is sold, consigned, or given away. <br /> wn Signature Print Name Date <br /> EHD 16-278/12/16 5 CFO REG/PERMITTING FORM <br />
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