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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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PR0547567
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COMPLIANCE INFO_2022
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Entry Properties
Last modified
3/31/2022 4:03:43 PM
Creation date
3/31/2022 4:01:54 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2022
RECORD_ID
PR0547567
PE
1608
FACILITY_ID
FA0027060
FACILITY_NAME
ASH BLOSSOM BAKERY
STREET_NUMBER
402
STREET_NAME
QUAIL RUN
STREET_TYPE
CIR
City
TRACY
Zip
95377
CURRENT_STATUS
01
SITE_LOCATION
402 QUAIL RUN CIR
P_LOCATION
03
QC Status
Approved
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SJGOV\jcastaneda
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EHD - Public
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SANg10AQ U I N Environmental Health Department <br /> —COUNTY— <br /> Sweet Sorghum Roasted Coffee <br /> ❑ Syrup ❑ (Beans/Grounds) FRr Chocolate Covered Nonperishable Food <br /> Fried or Baked <br /> E] Donuts and Waffles9 Dried Hot Chocolate ❑ Other <br /> Do not contain eggs,cream,or cream cheese <br /> "If preparing jams,jellies or fruit butters,include a list of ingredients(attach separate page if needed). These items <br /> must comply with standards described in Part 150 of Title 21 of the Code of Federal <br /> Regulations htto://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfCFR/CFRSearch.cfm?CFRPart=150 <br /> Food Descriptions: <br /> Cook;es '. Coaonv+ MAcaredn On4o7oa) 2a/^sin, f ean�+ 23y er; C4ecolak <br /> •a;Fk "A c6COW-C, tiac i lMIa NO', <br /> 1r 1i 1/J le C.koC',/al4f- I <br /> rndujaenct y <br /> �re e a ,Je� — 5 <br /> Mvhh'n 11 n <br /> fiacadamia Nu�/ //f�k¢�eo ;D J Trown S(1 ar ' n'can <br /> Cake. <br /> CDDraLS : CQrro+ Cd`F� - Cben"We., ,. '1JOJ10L� 6-,;"r>IrJ yeig4 <br /> * le d � ! ��A�o lr°� bUtf�rer`[am f�3�iM� T�ACaA7. Tla7 ie)ral <br /> Cand ICC , Cwra,vu,• 'Tof4 /• Try ate c Cl e)toll ears rre <br /> bri.A ba na � 4rle �erru CA1Ds JiPDaa ?, 01mem" y <br /> V � v . 4'A] &41- <br /> Uru rn;xes : CaI4s -404 Clec,9104 <br /> 2 of <br /> EHD 16.276129/17 CFO REGIPERMITTING FORM <br />
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