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COMPLIANCE INFO_2018-2020
EnvironmentalHealth
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1600 - Food Program
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PR0543396
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COMPLIANCE INFO_2018-2020
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Entry Properties
Last modified
12/11/2020 3:14:11 PM
Creation date
8/30/2019 3:13:58 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2018-2020
RECORD_ID
PR0543396
PE
1608
FACILITY_ID
FA0024636
FACILITY_NAME
SUGA RUSHD
STREET_NUMBER
10940
STREET_NAME
WILD BERRY
STREET_TYPE
LN
City
STOCKTON
Zip
95209
CURRENT_STATUS
01
SITE_LOCATION
10940 WILD BERRY LN
P_LOCATION
01
QC Status
Approved
Scanner
JCastaneda
Tags
EHD - Public
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9. Employee: Initial if you agree to abide by the following: 9-D <br /> _ <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: G <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, Chu ire �Q i/lr.(05 agree to grant access to the local health <br /> departm t to conduct an inspection of my cottage food operation (mark one) <br /> d"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, C�Na _Taw- S agree to notify the San Joaquin County <br /> Enviro ental 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 /> lt�Ay <br /> O is SiWature int Name Date <br /> EHD 16-27 213117 5 CFO REG/PERMUTING FORM <br />
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