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COMPLIANCE INFO_2021
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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WILLOW PARK
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1648
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1600 - Food Program
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PR0547160
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COMPLIANCE INFO_2021
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Entry Properties
Last modified
11/9/2021 12:50:30 PM
Creation date
9/22/2021 2:07:20 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0547160
PE
1608
FACILITY_ID
FA0026759
FACILITY_NAME
DWC POPP'N SNACKS
STREET_NUMBER
1648
STREET_NAME
WILLOW PARK
STREET_TYPE
WAY
City
STOCKTON
Zip
95206
CURRENT_STATUS
01
SITE_LOCATION
1648 WILLOW PARK WAY
P_LOCATION
01
QC Status
Approved
Scanner
SJGOV\jcastaneda
Tags
EHD - Public
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SANN J od��1 N Environmental Health Department <br /> J 0 I NJTY--- <br /> 9. <br /> -9. Employee: Initial if you agree to abide by the following: A <br /> I understand that I may not have more than one full-time equivalent cottage food employee, not including a <br /> family member or household member of the cottage food operator,working within the registered or permitted <br /> area of a private home where the cottage food operator resides and where cottage food products are prepared <br /> or packaged for direct, indirect, or direct and indirect sale to consumers. <br /> 10. Delivery Limitation: Initial if you agree to abide by the following: <br /> I understand that I may accept orders and payments via the internet, mail or phone. However, all "Class A" and <br /> "Class 6" 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 /> 11. Owner's <br /> ,IStatement: <br /> N �j�j��p <br /> `#16 �� '"" ' agree to grant access to the local health department to <br /> conduct aWinspection of my cottage food operation (mark one) <br /> Class A": In the event of a Consumer ❑ "Class B": For regular annual facility <br /> complaint or reported food-borne illness inspections and in the event of a consumer <br /> �] <br /> ,�, complaint or food-borne <br /> I, Ob �( � agree to notify the San Joaquin County <br /> Environni6ntal Health Department prior to modifying my food list,type of operation, and/or method of <br /> selling, distributing, or otherwise providing my CFO products to the consumer or retailers, regardless of <br /> whether t roduct is sol consigned, or given away. <br /> Owner's Signature Print a Date <br /> 5 of <br /> EHD 16-27 6/29/17 CFO REGIPERMITTING FORM <br />
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