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COMPLIANCE INFO_2022
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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1600 - Food Program
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PR0546499
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COMPLIANCE INFO_2022
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Entry Properties
Last modified
8/15/2022 3:59:19 PM
Creation date
2/9/2022 1:46:12 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2022
RECORD_ID
PR0546499
PE
1608
FACILITY_ID
FA0026362
FACILITY_NAME
CREATIVE COOKIES BY DIANA
STREET_NUMBER
7640
Direction
W
STREET_NAME
ALYCIA
STREET_TYPE
CT
City
TRACY
Zip
95304
CURRENT_STATUS
01
SITE_LOCATION
7640 W ALYCIA CT
P_LOCATION
03
QC Status
Approved
Scanner
SJGOV\jcastaneda
Tags
EHD - Public
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SAN J0AQ U I N Environmental Health Department <br /> COUNTY <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 internet, mail or phone. However, all "Cla s "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. Owner's Statement: <br /> I, t ✓ ` � ��r �1� agree to grant access to the local health department to <br /> conduct an inspection of my cottage food operation (mark one) <br /> cClass A": In the event of a consumer El "Class B": For regular annual facility inspections <br /> omplaint or reported food-bome illness and in the event of a consumer complaint or <br /> ��t food-borne illness <br /> • l. 5agree to notify the San Joaquin County Environmental <br /> Health Department'pdbr 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 /> consigned, or given away. <br /> ayuk- Vl� S I � -2— <br /> Owne Si ature V Print Name Date <br /> MADE IN A HOME KITCHEN <br /> Permit#VM27838 ✓ <br /> Creative Cookies by Diana <br /> 1("m W Alycia Ct Trny h 95309 <br /> ingredients:Enriched unbleached wheat flour(whear Flow,Niacin,Reduced Iraq Thiamin, <br /> Mononitrate,Riboflavin,Folilc acid)Malted barley flow,sugar,buner(pasteurind cream(milk)salt, <br /> organic eggs,brown sugar,salt,laking powder,pw<vanilla extrect(vanilla been extractives in water, <br /> alcohol(35%) <br /> Icing Ingredients:Powdered sugar(sugar,com starch)water,meringue powder(modified food starch, <br /> egg whites,sugar,gum arabic,sodium aluminum sulfate,citric acid,emam of tartar,vanillin)Com <br /> symp,(com symp,salt,vanilla)Natural and artificial flavoring,fund dye <br /> Contains:Wheat,eggs,milk <br /> Net Wt.3oz(85.049g) <br /> 2 of <br />
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