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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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1600 - Food Program
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PR0545599
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COMPLIANCE INFO_COMPLIANCE INFO 2020
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Entry Properties
Last modified
4/22/2020 8:20:56 AM
Creation date
4/22/2020 8:15:56 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
COMPLIANCE INFO 2020
RECORD_ID
PR0545599
PE
1608
FACILITY_ID
FA0025868
FACILITY_NAME
GRAVITY BIRD BAKERY
STREET_NUMBER
1434
STREET_NAME
MARIPOSA
STREET_TYPE
WAY
City
LODI
Zip
95242
CURRENT_STATUS
01
SITE_LOCATION
1434 MARIPOSA WAY
P_LOCATION
02
QC Status
Approved
Scanner
JCastaneda
Tags
EHD - Public
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SAN-JOAQUIN <br />--COUNTY <br />Environmental Health Department <br />❑ Sweet Sorghum ❑ Roasted Coffee ❑ Chocolate Covered Nonperishable Food <br />Syrup (Beans/Grounds) <br />❑ Fried or Baked ❑ Dried Hot Chocolate ❑ Other <br />Donuts and Waffles <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 <br />Regulations http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfCFR/CFRSearch.cfm?CFRPart=150 <br />Food Descriptions: <br />U/: AA -rm�Ap hr_,n!1-aPCIr,n'0A ( -of '> ')I JN-kMn iO[okI�-S <br />F2 <br />Z) A A I - <br />v <br />J <br />6i Y'\ �\A - p a d" <br />�) �he��tno Ci�c�<i� mG�P Ghr�SP +ZRplbCCc <br />41 ,,t r r 00 G k) v-HfC a a -I r\� Sa l� > <br />2 of 5 <br />EHD 16-27 6/29/17 CFO REG/PERMITTING FORM <br />
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