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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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PR0547290
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COMPLIANCE INFO_2022
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Entry Properties
Last modified
12/21/2022 3:17:24 PM
Creation date
12/21/2022 3:16:16 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2022
RECORD_ID
PR0547290
PE
1608
FACILITY_ID
FA0026860
FACILITY_NAME
MR WINTEAS
STREET_NUMBER
23346
Direction
S
STREET_NAME
FREDERICK
STREET_TYPE
RD
City
RIPON
Zip
95366
CURRENT_STATUS
01
SITE_LOCATION
23346 S FREDERICK RD
P_LOCATION
05
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 />CE <br />7. 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 "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 />Clint Elliott <br />I, agree to grant access to the local health department to <br />conduct an inspection of my cottage food operation (mark one) <br />P� "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 -borne illness <br />Clint Elliott <br />I, 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 given away. <br />CE <br />Clint Elliott <br />10-31-2022 <br />Owners Signature Print Name Date <br />EHD. 16-286/27/22 2 CFO REG/PERMITTING RENEWAL FORM <br />
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