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COMPLIANCE INFO_2021
EnvironmentalHealth
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1600 - Food Program
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PR0545470
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COMPLIANCE INFO_2021
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Entry Properties
Last modified
3/17/2021 9:31:00 AM
Creation date
3/17/2021 9:29:23 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0545470
PE
1608
FACILITY_ID
FA0025816
FACILITY_NAME
VILLASBOAS&GOMES ENT LLC
STREET_NUMBER
274
STREET_NAME
COLLINS
STREET_TYPE
AVE
City
MOUNTAIN HOUSE
Zip
95391
CURRENT_STATUS
02
SITE_LOCATION
274 COLLINS AVE
P_LOCATION
99
QC Status
Approved
Scanner
SJGOV\jcastaneda
Tags
EHD - Public
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SANJ O A Q U I N Environmental Health Department <br /> COUNTY- <br /> 7. Delivery Limitation: Initial if you agree to abide by the following: LG <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 /> Luciano Gomes agree to grant access to the local health department to <br /> conduct an inspection of my cottage food operation (mark one) <br /> ® "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 /> Luciano Gomes 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 /> zzzo�yyg Wi V±Pxe y Luciano I. Gomes 02/20/2021 <br /> Owner's Si ature Print Name Date <br /> 2 oft <br />
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