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COMPLIANCE INFO_2022
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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GOLDEN POND
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1600 - Food Program
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PR0547456
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COMPLIANCE INFO_2022
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Entry Properties
Last modified
3/2/2023 10:46:38 AM
Creation date
2/17/2022 11:54:50 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2022
RECORD_ID
PR0547456
PE
1609
FACILITY_ID
FA0026982
FACILITY_NAME
FERMENT & GRIND
STREET_NUMBER
894
STREET_NAME
GOLDEN POND
STREET_TYPE
DR
City
MANTECA
Zip
95336
CURRENT_STATUS
01
SITE_LOCATION
894 GOLDEN POND DR
P_LOCATION
04
QC Status
Approved
Scanner
SJGOV\jcastaneda
Tags
EHD - Public
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SAN JOAQUiN <br />— COUNTY -- <br />Environmental Health Department <br />7. Delivery Limitation: Initial if you agree to abide by the followin <br />I understand that I may accept orders and payments via the internet, mail or phone. However all " lass K and <br />"Class B" CFO products must be delivered directly (in person) to the customer. The CFO pro cts ay not be <br />delivered via the United States Postal Service, UPS, FedEx, or using any other indirect delive ethod as <br />deliveries are regulated by, and subject to, CDPH registration and state and federal requirements. <br />8. Owner's Statement: <br />I, ix,yr, I) lb , agree to grant access to the local health department to <br />conduct an inspection of my col age food operation (nmark one) <br />❑ "Class A": In the event of a consumer I�{ "Class B": For regular annual facility inspections <br />complaint or reported food -borne illness ' \ and in the event of a consumer complaint or <br />food -borne illness <br />I, 16— gr ) gq , agree to notify the San Joaquin County Environmental <br />Health Department prior to difying 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 />0, z / -�Z_ , za� <br />wne <br />es ' ature Print Name Date <br />2of2 <br />
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