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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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PR0544073
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COMPLIANCE INFO_2022
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Entry Properties
Last modified
4/28/2022 9:53:19 AM
Creation date
4/28/2022 9:47:04 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2022
RECORD_ID
PR0544073
PE
1608
FACILITY_ID
FA0025069
FACILITY_NAME
SHELLY'S SUGAR SHAK
STREET_NUMBER
539
Direction
E
STREET_NAME
BARRYMORE
STREET_TYPE
ST
City
STOCKTON
Zip
95204-2208
CURRENT_STATUS
01
SITE_LOCATION
539 E BARRYMORE ST
P_LOCATION
01
QC Status
Approved
Scanner
SJGOV\jcastaneda
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EHD - Public
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SAN10 A Q U I N Environmental Health Department <br /> �-0UNTY <br /> Sweet Sorghum Roasted Coffee <br /> Syrup ❑ (Beans/Grounds) ❑ Chocolate Covered Nonperishable Food <br /> Fried or Baked <br /> Donuts and Waffles El 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 http:// m.accessdata.fda. ovlscri tslcdrhlcfdocslcfCFR/CFRSearch.cfm?CFRPart-150 <br /> Food Descriptions: <br /> llGKes OnICts OUtd 061lus 0AV-1 L s <br /> C � [A 5ci 1 GAS 0 u, ovt g Vx, 5, C I4 oto <br /> 2 of 5 <br /> EHD 16-27 6129117 CFO REGIPERMITCING FORM <br />
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