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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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SANJ O A Q U I N Environmental Health Department <br /> -COUNTY <br /> 9. Employee: Initial if you agree to abide by the following: <br /> I understand that I may not have more than one full-time equivalent cottage food employee, not i clu ng a <br /> family member or household member of the cottage food operator, working within the registered rmitted <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' I A"and <br /> "Class B"CFO products must be delivered directly(in person)to the customer.The CFO products m not be <br /> delivered via the United States Postal Service, UPS, FedEx, or using any other indirect delivery me od as <br /> deliveries are regulated by, and subject to, CDPH registration and state and federal requirements. <br /> 11. Owner's Statement: <br /> I, agree to grant access to the local health department to <br /> conduc n inspection of my cottage 7 operation (mark one) <br /> KCoClass A": In the event of a co sumer ❑ "Class B": For regular annual facility <br /> mplaint or reported food-borne illness inspections and in the event of a consumer <br /> ��/ �L 7 / complaint or food-borne <br /> I, `® ' G /oe4//4 // agree to notify the San Joaquin County <br /> Environmental Health Department pri r 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 /> hether the product is sold, c led, or given away. <br /> VV <br /> ner's Signature V Print Name Date <br /> 5 of <br /> EHD 16-27 6/29/17 CFO REG/PERMITTING FORM <br />
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