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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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PR0546590
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COMPLIANCE INFO_2021
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Entry Properties
Last modified
5/18/2021 4:40:44 PM
Creation date
4/2/2021 4:01:02 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0546590
PE
1608
FACILITY_ID
FA0026429
FACILITY_NAME
PRISCILLA MUNOZ'S ARTISAN SOURDOUGH BREAD & BAKED SWEETS
STREET_NUMBER
2063
STREET_NAME
DOROTHY
STREET_TYPE
LN
City
TRACY
Zip
95376
CURRENT_STATUS
01
SITE_LOCATION
2063 DOROTHY LN
P_LOCATION
03
QC Status
Approved
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SJGOV\jcastaneda
Tags
EHD - Public
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S A N JO A Q U IN Environmental Health Department <br /> - <br /> Sweet Sorghum Roasted Coffee <br /> COUNTY— <br /> El Syrup El (Beans/Grounds) ❑ Chocolate Covered Nonperishable Food <br /> dFried or Baked ❑ Dried Hot Chocolate ❑ Other <br /> Donuts and Waffles <br /> i <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 hfti):/A&ww.accessdata.fda.gov/scriptsicdrh/cfdocs/cfCFRICFRSe rch.cfm?CFRPart=150 <br /> Food Descriptions: nn 1_ <br /> Ciy1CAI of Set�r f �n F]y�fCds <br /> '3 VAS, C W1 CACS <br /> VGt'�ry F'� nas�-ri,4, <br /> 2of5 <br /> EHD 16.27 6/29/17 CFO REGIPERMnTING FORM <br />
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