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COMPLIANCE INFO_2016-2019
EnvironmentalHealth
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1600 - Food Program
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PR0540811
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COMPLIANCE INFO_2016-2019
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Entry Properties
Last modified
9/29/2020 4:45:40 PM
Creation date
4/30/2019 10:51:54 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2016-2019
RECORD_ID
PR0540811
PE
1609
FACILITY_ID
FA0023332
FACILITY_NAME
BLOOM BAKERY
STREET_NUMBER
1835
STREET_NAME
PIEDMONT
STREET_TYPE
DR
City
MANTECA
Zip
95336
CURRENT_STATUS
01
SITE_LOCATION
1835 PIEDMONT DR
P_LOCATION
04
QC Status
Approved
Scanner
JCastaneda
Tags
EHD - Public
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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 <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 /> 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 <br /> A" and "Class B" CFO products must be delivered directly(in person) to the customer. The CFO products <br /> may not be delivered via the United States Postal Service, UPS, FedEx, or using any other indirect <br /> delivery method as deliveries are regulated by, and subject to, CDPH registration and state and federal <br /> requirements. <br /> 11. Owner's Statement: <br /> I, L�iAAa . ;D- LAI4 , agree to grant access to the local health <br /> department to conduct an iroection 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 /> I, agree to notify the San Joaquin County <br /> Environmental Health 130ment prior to modifying my food list, type of operation, and/or method <br /> of selling, distributing, or othtrwise providing my CFO products to the consumer or retailers, <br /> regardless of whether the product is sold, consigned, or given away. <br /> wner's i ature Print Name D to <br /> EHD 16-27 6/29/2015 5 CFO REG/PERMITTING FORM <br />
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