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COMPLIANCE INFO_2017-2019
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1600 - Food Program
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PR0541790
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COMPLIANCE INFO_2017-2019
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Entry Properties
Last modified
12/11/2020 3:11:50 PM
Creation date
6/6/2019 2:33:33 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2017-2019
RECORD_ID
PR0541790
PE
1608
FACILITY_ID
FA0023958
FACILITY_NAME
THE BARN BAKE SHOP
STREET_NUMBER
20199
STREET_NAME
WICKLUND
STREET_TYPE
RD
City
TRACY
Zip
95391
CURRENT_STATUS
01
SITE_LOCATION
20199 WICKLUND RD
P_LOCATION
03
QC Status
Approved
Scanner
JCastaneda
Tags
EHD - Public
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• J'AN ,, J 0 A Q U I N Environmental Health Department <br /> COUNTY— <br /> 7. 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 " la " and <br /> "Class B" CFO products must be delivered directly (in person) to the customer. The CFO products y 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 /> 8. Owner's Statement: <br /> 1, V (_QL 1)SO*-) agree to grant access to the local health department to <br /> conduct an inspection of my cottage food operation (mark one) <br /> " lass 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, •k4c Q J, \, (.� agree to notify the San Joaquin County Environmental <br /> Health Department prior to modifying my food list, type of operation, and/or method of selling, distributing, or <br /> otherwise providing my CFO products to the consumer or retailers, regardless of whether the product is sold, <br /> consigned, or ay. <br /> %A %k k b 1, IN, <br /> sC� Z I <br /> wners at Print Name Date <br /> 2of2 <br />
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