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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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PR0546214
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COMPLIANCE INFO_2020
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Entry Properties
Last modified
9/29/2020 9:27:59 AM
Creation date
9/29/2020 9:27:29 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2020
RECORD_ID
PR0546214
PE
1608
FACILITY_ID
FA0026159
FACILITY_NAME
DULCES BY DEILANI
STREET_NUMBER
9426
STREET_NAME
BONANZA
STREET_TYPE
DR
City
STOCKTON
Zip
95209
CURRENT_STATUS
01
SITE_LOCATION
9426 BONANZA DR
P_LOCATION
01
QC Status
Approved
Scanner
JCastaneda
Tags
EHD - Public
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S R N ,� O A Q�t�I IN <br /> Environmental Health Department <br /> rl C O U N TYI' <br /> 9. Employee: Initial if you agree to abide by the following: <br /> I understand that I may not have more than one full-time equivalent cottage food employee, not including a <br /> family member or household member of the cottage food operator, working within the registered or permitted <br /> area of a private home where the cottage food operator resides and where cottage food products are prepared <br /> or packaged for direct, indirect, or direct and indirect sale to consumers. <br /> 10. Delivery Limitation: Initial if you agree to abide by the following: <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 /> 11. Owner's Statement: <br /> I, U/U l agree to grant access to the local health department to <br /> conduct an inspection o my cottage food operation (mark one) <br /> `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 Vl f�'1 agree to notify the San Joaquin County <br /> En ironmental Health Department prior to modifying my food list, type of operation, and/or method of <br /> selling, distributing, or otherwise providing my CFO products to the consumer or retailers, regardless of <br /> whether the product is sold, consigned, or given away. <br /> I <br /> wner`s Signature Print Name Date <br /> 5 of 5 <br /> E H D 16-27 6/29/17 CFO REG/PERMITTING FORM <br />
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