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COMPLIANCE INFO_COMPLIANCE INFO 2020
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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ELM
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1600 - Food Program
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PR0541456
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COMPLIANCE INFO_COMPLIANCE INFO 2020
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Entry Properties
Last modified
4/3/2020 2:53:08 PM
Creation date
4/3/2020 2:52:28 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
COMPLIANCE INFO 2020
RECORD_ID
PR0541456
PE
1608
FACILITY_ID
FA0023767
FACILITY_NAME
CHARITOS CAKES
STREET_NUMBER
521
Direction
E
STREET_NAME
ELM
STREET_TYPE
ST
City
LODI
Zip
95240
CURRENT_STATUS
01
SITE_LOCATION
521 E ELM ST APT #3
P_LOCATION
02
QC Status
Approved
Scanner
JCastaneda
Tags
EHD - Public
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r <br /> SA N sd 0 Q Q U IN Environmental Health Department <br /> —COUNTY- <br /> 7. <br /> OUNTY7. Delivery Limitation: Initial if you agree to abide by the following: gAl <br /> I 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 directly (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 /> 8. Owner's Statement: <br /> I, d(, r � cA I((' (\0C?1 cT_, 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 /> 1, &T I�a Mal2d l CJ I C'a 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 given away. <br /> _Jcr�__ .9,/ r i CA 61YO 10 1 C1 2 2 <br /> Owner's Signature Print Name Date <br /> 2 of 2 <br />
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