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COMPLIANCE INFO_2021
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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1600 - Food Program
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PR0547289
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COMPLIANCE INFO_2021
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Entry Properties
Last modified
11/30/2021 4:04:43 PM
Creation date
11/30/2021 4:02:26 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0547289
PE
1608
FACILITY_ID
FA0026859
FACILITY_NAME
POPAHOLIKS POPKORN
STREET_NUMBER
402
Direction
W
STREET_NAME
CENTURY
STREET_TYPE
BLVD
City
LODI
Zip
95240
CURRENT_STATUS
01
SITE_LOCATION
402 W CENTURY BLVD
P_LOCATION
02
QC Status
Approved
Scanner
SJGOV\jcastaneda
Tags
EHD - Public
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SANJ O A Q U I N Environmental Health Department <br />t <br />9. Employee: Initial if you agree to abide by the following: p <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. ► r / ' <br />10. Delivery Limitation: Initial if you agree to abide by the following: Iy v <br />I understand that I may accept orders and payments via the internet, 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 />11. Owner's Statement: <br />1, W ` lim m)6W agree to grant access to the local health department to <br />conduct an inspection of my cottage food operation (mark one) <br />"Class A": In the event of a consumer E] "Class B": For regular annual facility <br />mplaint or reported food -borne illness inspections and in the event of a consumer <br />complaint or food -borne <br />I, � +u U)�C/vW , agree to notify the San Joaquin County <br />Environmental 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 the product is sold, consigned, or given away. <br />5 Of <br />EHD 16-27 6/29/17 CFO REG/PERMITTING FORM <br />
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