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COMPLIANCE INFO
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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1424
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1600 - Food Program
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PR0543483
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COMPLIANCE INFO
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Entry Properties
Last modified
5/29/2020 1:14:48 PM
Creation date
7/2/2019 2:43:01 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0543483
PE
1608
FACILITY_ID
FA0024682
FACILITY_NAME
THIRSTY BEAR
STREET_NUMBER
1424
Direction
W
STREET_NAME
LOCUST
STREET_TYPE
ST
City
LODI
Zip
95242
CURRENT_STATUS
04
SITE_LOCATION
1424 W LOCUST ST
P_LOCATION
02
QC Status
Approved
Scanner
JCastaneda
Tags
EHD - Public
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❑ Dried or Dehydrated ❑ Dried Vegetarian- ❑ Vegetable and Potato Chips <br /> Vegetables Based Soup Mixes <br /> ❑ Sweet Sorghum 5d Roasted Coffee El Chocolate Covered Nonperishable Food <br /> Syrup 1� (Beans/Grounds) <br /> Fried or Baked <br /> El Donuts and WafflesElDried Hot Chocolate E] Fruit Infused Balsamic Vinegar <br /> ❑ Other <br /> Do not contain eggs,cream,or cream cheese <br /> '•If preparing jams,jellies or fruit butters,include a list of ingredients(attach separate page if needed). These items <br /> must comply with standards described in Part 150 of Title 21 of the Code of Federal Regulations <br /> http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfCFR/CFRSearch.cfm?CFRPart=150 <br /> Food Descriptions: <br /> e rnaSf 3nd Do)G dclrz-g& 0AV . <br /> 4� Clio 404 ndic cors <br /> EHD 16-272/3/17 2 CFO REG/PERMrrr1NG FORM <br />
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