My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
COMPLIANCE INFO_2021
EnvironmentalHealth
>
EHD Program Facility Records by Street Name
>
C
>
CANCION
>
535
>
1600 - Food Program
>
PR0538891
>
COMPLIANCE INFO_2021
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
5/6/2021 3:31:54 PM
Creation date
4/21/2021 4:30:22 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0538891
PE
1609
FACILITY_ID
FA0022345
FACILITY_NAME
KAY'S CREATIONS
STREET_NUMBER
535
Direction
W
STREET_NAME
CANCION
STREET_TYPE
CT
City
MOUNTAIN HOUSE
Zip
95391
APN
25442004
CURRENT_STATUS
01
SITE_LOCATION
535 W CANCION CT
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\jcastaneda
Tags
EHD - Public
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
6
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
SAN,JOAQUIN <br />COUNTY <br />Greatness grows ne;: <br />CFO Business Name: <br />Environmental Health 9,& 6Mftvnt <br />RECEIVED <br />APR 15 2021 <br />COTTAGE FOOD OPERATIONS (CFO) SAN JOAQUIN <br />COUNTY <br />ENVIRONMENTAL <br />REGISTRATION/PERMITTING RENEWAL FORM HEALTH DEPARTMENT <br />Owner Name: <br />CFO Physical Address: CFO City: CFO Zip: <br />5 3S W . CAW C40 1,) GT MOiMATPmJ 1%u SE Cly- 15-391 <br />Website (If applicable): Telephone: <br />www•Y-&NSV1ACA17-0%gS.cOVw 1240 <br />1. Categories: <br />❑ "Class A" (Direct Sales Only) $155 "Class B" (Direct & Indirect Sales) $310 <br />2. Prohibited Items: Initial if you agree to abide by the following: KE <br />Foodscontaining cream, custard, or meat fillings are potentially hazardous and are NOT ALLOWED. Only <br />foods that are defined as "non -potentially hazardous" are approved for preparation by a Cottage Food Operation. <br />These foods include items that do not require refrigeration to keep them safe from bacterial growth that could be a <br />cause of food -borne illness. <br />3. Products: <br />Provide a list of all products you are preparing. If preparing jams, jellies, or fruit butters include a list of <br />ingredients (attach separate page if needed). <br />Food List: MX4 <br />r10\.A%'21 E6(nSt SI.tCIA-k2� <br />soy A'VJ\> PA-%kPq . <br />4. Product Labeling: <br />Attach two labels to this form for two of your CFO products (only one label is required if only one product is <br />made). <br />5. Water Source: (J o p p <br />Please check what type of water source is being used at the CFO: ` t� 3C� O C=t 1 <br />City Water ❑ Private Well* <br />*If a private well, attach all updated water sample results (including quarterly bacteria and Nitrate results.) <br />6. Food Processor Course: <br />Attach food handler certification for owner and each individual that were not submitted with initial application <br />(including family members and/or employees). <br />1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />
The URL can be used to link to this page
Your browser does not support the video tag.