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COMPLIANCE INFO_2021
EnvironmentalHealth
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1600 - Food Program
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PR0542092
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COMPLIANCE INFO_2021
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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
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J H 11 ) U H W U 1 1 <br />C (-) U N —1 Y <br />7. Delivery Limitation: Initial if you agree to abide by the following: <br />I understand that I may accept orders and payments via the intemet, 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. Owners Statement: <br />ja"! <br />1, I 'I " 1`Tapt--- , agree to grant access to the local health department to <br />conduct an inspection of my cottage food operation (mark one) <br />t11 "Class A": In the event of a consumer ❑ "Class B": For regular annual facility inspections <br />G� complaint or reported food-bome illness and in the event of a consumer complaint or <br />�i food-bome illness <br />hal 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 />nsigned, or given away. <br />Owner's Signature Print Name Date <br />2 of <br />
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