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COMPLIANCE INFO_2022
EnvironmentalHealth
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1600 - Food Program
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PR0547637
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COMPLIANCE INFO_2022
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Entry Properties
Last modified
5/16/2022 9:48:16 AM
Creation date
5/2/2022 8:11:07 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2022
RECORD_ID
PR0547637
PE
1609
FACILITY_ID
FA0027120
FACILITY_NAME
MY COOKIE
STREET_NUMBER
469
STREET_NAME
GLENBRIAR
STREET_TYPE
CIR
City
TRACY
Zip
95377
CURRENT_STATUS
01
SITE_LOCATION
469 GLENBRIAR CIR
P_LOCATION
03
QC Status
Approved
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SJGOV\jcastaneda
Tags
EHD - Public
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SAN JOAQUIN <br />- COUNTY ------ <br />Sweet Sorghum <br />El Syrup <br />Fried or Baked <br />Donuts and Waffles <br />Environmental Health Department <br />Roasted Coffee <br />E] Roasted <br />❑ Chocolate Covered Nonperishable Food <br />❑ Dried Hot Chocolate ❑ <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 />oa+rneal t raisin/choc-otate chip cooKieS <br />• raisin — nv+ aranoia <br />• 6lueberr.r yam <br />• atcoYiad dri4 -Wyiks <br />krait mix <br />2 of <br />EHD 16-276/29/17 CFO REG/PERMITTING FORM <br />
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