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COMPLIANCE INFO_2021
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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1600 - Food Program
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PR0545237
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COMPLIANCE INFO_2021
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Entry Properties
Last modified
2/17/2021 3:28:54 PM
Creation date
2/17/2021 3:25:21 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0545237
PE
1608
FACILITY_ID
FA0025724
FACILITY_NAME
SHELLY'S BOMBS
STREET_NUMBER
16710
STREET_NAME
VICTORIAN
STREET_TYPE
TR
City
LATHROP
Zip
95330
CURRENT_STATUS
01
SITE_LOCATION
16710 VICTORIAN TR
P_LOCATION
07
QC Status
Approved
Scanner
SJGOV\jcastaneda
Tags
EHD - Public
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i <br /> SA N A A Q U IN Environmental Health Department <br /> COUNTY <br /> 7. Delivery Limitation: Initial if you agree to abide by the following: 4n�D <br /> 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[ xAs agree to grant access to the local health department to <br /> conduct an inspection of my cottage food operation (mark one) <br /> -EA"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 /> I, m 0,cj n elle Wk I.1 cNyc,�S 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 /> \1MV%CxM in <br /> wner's Signature Print Name Dafe <br /> 2 of 2 <br />
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