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COMPLIANCE INFO_2021
EnvironmentalHealth
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1600 - Food Program
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PR0545817
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COMPLIANCE INFO_2021
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Entry Properties
Last modified
9/22/2021 3:31:38 PM
Creation date
9/22/2021 3:30:40 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0545817
PE
1608
FACILITY_ID
FA0025926
FACILITY_NAME
UNDERGROUND
STREET_NUMBER
15377
STREET_NAME
JEWEL
STREET_TYPE
ST
City
LATHROP
Zip
95330
CURRENT_STATUS
01
SITE_LOCATION
15377 JEWEL ST
P_LOCATION
98
QC Status
Approved
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SJGOV\jcastaneda
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EHD - Public
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MADE IN A HOME KITCHEN <br />Permit Number: <br />Issues in San Joaquin County <br />UNDERGROUND — Permit #:PT0027472 <br />Sharon Addison <br />15377 Jewel Street <br />Lathrop, CA. 95330 <br />BELGIEN WAFFLE (CHOCOLATE CHIP FLAVOR WITH SPRINKLES) <br />INGREDIENTS: Enriched bleached flour (wheat flour, malted barley flour, niacin, <br />reduced iron, thiamin mononitrate, riboflavin, folic acid), sugar, leavening (baking <br />soda, sodium aluminum phosphate, monocalcium phosphate), maltodextrin, salt, <br />dextrose, isolated soy protein, soybean oil, natural flavor, soy lecithin, Nestle milk <br />chocolate chips. <br />CHOCOLATE CHIP FLAVOR WITH SPRINKLES <br />INGREDIENTS (Flavor): Chocolate extract, cocoa bean extractives water, <br />CANDY SPRINKLES: SUGAR, CORNSTARCH, PALM OIL, PALM KERNEL OIL, COCOA, <br />COCOA PROCESSED WITH ALKALI, SOY LECITHIN, CONFECTIONER'S GLAZE <br />(SHELLAC), YELLOW 5 LAKE, RED yo LAKE, YELLOW 6 LAKE, BLUE i LAKE, RED 3, <br />NATURAL AND ARTIFICIAL FLAVOR, CARNAUBA WAX, BLUE i. <br />Net Wt. 3.78 oz <br />MADE IN A HOME KITCHEN <br />Permit Number: <br />Issues in San Joaquin County <br />UNDERGROUND — Permit #:PT0027472 <br />Sharon Addison <br />15377 Jewel Street <br />Lathrop, CA. 95330 <br />Maple Syrup: 100% Maple Syrup. <br />
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