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COMPLIANCE INFO
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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BROOKFIELD
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1600 - Food Program
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PR0544179
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COMPLIANCE INFO
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Entry Properties
Last modified
3/26/2019 8:43:37 AM
Creation date
3/26/2019 8:42:44 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0544179
PE
1608
FACILITY_ID
FA0025120
FACILITY_NAME
LYRIC'S LEGACY
STREET_NUMBER
915
STREET_NAME
BROOKFIELD
STREET_TYPE
AVE
City
LATHROP
Zip
95330
CURRENT_STATUS
01
SITE_LOCATION
915 BROOKFIELD AVE
P_LOCATION
07
QC Status
Approved
Scanner
JCastaneda
Tags
EHD - Public
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S A I r i 0 A Q U IN <br /> Environmental Health Department <br /> — 'C 0UNTY--- <br /> 7. Delivery Limitation: Initial if you agree to abide by the following. <br /> 9 <br /> 1 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 direct) (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 /> g. Owner's Statement: <br /> I, hk� ks e k A 0 `� ` , agree to grant access to the local health department to <br /> 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 inspections <br /> complaint or reported food-borne illness and in the event of a consumer complaint or <br /> food-borne illness <br /> I, Y <.kAV_U , agree to notify the San Joaquin County Environmental <br /> Health Departmen rior to modifying fy d list, type of operation, and/or method of selling, distributing, or <br /> otherwise providinginly CFO products o the onsumer or retailers, regardless of whether the product is sold, <br /> consigned, o n a ay. <br /> Owner's ature Print Name Date <br /> 2 of 2 <br />
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