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COMPLIANCE INFO_2020
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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PIEDMONT
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1600 - Food Program
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PR0540811
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COMPLIANCE INFO_2020
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Entry Properties
Last modified
9/29/2020 4:49:45 PM
Creation date
4/24/2020 11:01:34 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2020
RECORD_ID
PR0540811
PE
1609
FACILITY_ID
FA0023332
FACILITY_NAME
BLOOM BAKERY
STREET_NUMBER
1835
STREET_NAME
PIEDMONT
STREET_TYPE
DR
City
MANTECA
Zip
95336
CURRENT_STATUS
01
SITE_LOCATION
1835 PIEDMONT DR
P_LOCATION
04
QC Status
Approved
Scanner
JCastaneda
Tags
EHD - Public
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• Environmental Health Department <br /> SAN�JOAQUIN <br /> COUNTY <br /> 7. Delivery Limitation: Initial if you agree to abide by the following: L p_ <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, I .f a, T)- Ocop, agree to grant access to the local health department to <br /> conduct an inspection of m cottage food operation (mark one) <br /> ❑ "Class A": In the event of a consumer If "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 /> agree to notify the San Joaquin County Environmental <br /> Health Department prior to modying 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 /> Lio�,L D 3 2e <br /> Owner's SiLOature Print Name Date <br /> 2 of 2 <br />
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