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COMPLIANCE INFO_2021
EnvironmentalHealth
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1600 - Food Program
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PR0546574
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COMPLIANCE INFO_2021
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Entry Properties
Last modified
3/16/2021 2:48:15 PM
Creation date
3/16/2021 2:37:43 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0546574
PE
1608
FACILITY_ID
FA0026418
FACILITY_NAME
SUAMALIE ANO
STREET_NUMBER
1571
STREET_NAME
PEONY
STREET_TYPE
DR
City
TRACY
Zip
95377
CURRENT_STATUS
01
SITE_LOCATION
1571 PEONY DR
P_LOCATION
03
QC Status
Approved
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SJGOV\jcastaneda
Tags
EHD - Public
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r <br /> SANJ O A Q U I N Environmental Health Department <br /> COUNTY— <br /> E] <br /> OUNTY❑ 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:/lw .accessdata.fda.gov/scripts/cdrh/cfdoGs/cfCFRICFRSearch.cfm?CFRPart=150 <br /> Food Descriptions: Vegan Based Products <br /> Pineapple Empanadas, Shortbread Cookies with Jam, Chocolate Chip Cookies, <br /> White Chocolate Macadamia Cookies, Fried/Baked Round Donuts, Ube Rolls, Cakes, <br /> Tarn Chips, Dry Raking Mixes, and Pineapple Jam <br /> 2 of5 <br /> EHD 19-27 6/29/17 CFO REG/PERMITTING FORM <br />
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