My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
COMPLIANCE INFO_2021
EnvironmentalHealth
>
EHD Program Facility Records by Street Name
>
B
>
BADGER
>
1533
>
1600 - Food Program
>
PR0542092
>
COMPLIANCE INFO_2021
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
6/10/2021 11:33:22 AM
Creation date
6/10/2021 11:30:51 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0542092
PE
1608
FACILITY_ID
FA0024172
FACILITY_NAME
BLACK STRAWBERRY BAKERY
STREET_NUMBER
1533
STREET_NAME
BADGER
STREET_TYPE
WAY
City
TRACY
Zip
95304
CURRENT_STATUS
01
SITE_LOCATION
1533 BADGER WAY
P_LOCATION
03
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.
/
7
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
t:7 (A � z <br />SAN 10A Q U I N Environmental Health Department <br />-- _(DurJ <br />COTTAGE FOOD OPERATIONS (CFO) <br />REGISTRATION/PERMITTING RENEWAL FORM <br />Ovmer Name: <br />CFO Physical Address: CVO City: CFO Z!p: <br />Website Qfa ;cable): v V Telephone: <br />lam- , lau l�v� ,eta Zo q. X55 l9 S j <br />1�. Categories: <br />p[� "Class A" (Direct Sales Only) $155 El "Class B" (Direct & Indirect Sales) $310 <br />2. ` Prohibited Items: Initial if you agree to abide by the following: - <br />Foods containing cream, custard, or meat fillings are potentially hazardous and are NOT A WED. 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-bome 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: .'�VpkLE ,r <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: <br />Flese check what type of water source is being used at the CFO: <br />CRy Water ❑ Private Well* <br />*If aaa 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 />5 <br />
The URL can be used to link to this page
Your browser does not support the video tag.