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COMPLIANCE INFO_2022
EnvironmentalHealth
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1600 - Food Program
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PR0544773
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COMPLIANCE INFO_2022
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Entry Properties
Last modified
12/6/2022 3:55:26 PM
Creation date
11/1/2022 11:19:12 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2022
RECORD_ID
PR0544773
PE
1608
FACILITY_ID
FA0025450
FACILITY_NAME
QUEENS BAKERY 209
STREET_NUMBER
259
STREET_NAME
PESTANA
STREET_TYPE
AVE
City
MANTECA
Zip
95336
CURRENT_STATUS
01
SITE_LOCATION
259 PESTANA AVE APT 3
P_LOCATION
04
QC Status
Approved
Scanner
SJGOV\jcastaneda
Tags
EHD - Public
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SANAAQU IN Environmental Health Department <br /> COUNT\ — <br /> 7. Delivery Limitation: Initial if you agree to abide by the following: da <br /> I understand that I may accept orders and payments via the internet, mail or phone. However, all"Class A"and <br /> "Class B"CFO products must be delivered directly(in person)to the customer.The CFO products may not be <br /> delivered via the United States Postal Service, UPS, FedEx,or using any other indirect delivery method as <br /> deliveries are regulated by, and subject to, CDPH registration and state and federal requirements. <br /> 8. Owner's Statement: <br /> 1. Dora Escobar agree to grant access to the local health department to <br /> conduct an inspection of my cottage food operation (mark one) <br /> "Class A": In the event of a consumer ❑ "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-bome illness <br /> Dora Escobar agree to notify the San Joaquin County Environmental <br /> Health Department prior to modifying 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 giiv�eyn�away. <br /> C' " Dora Escobar 08/2612021 <br /> Owner's Signature Print Name Date <br /> 2 oft <br />
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