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COMPLIANCE INFO_2023
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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CLEMENTINE CRT
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1600 - Food Program
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PR0548099
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COMPLIANCE INFO_2023
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Entry Properties
Last modified
11/20/2023 2:51:19 PM
Creation date
3/15/2023 12:59:41 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2023
RECORD_ID
PR0548099
PE
1608
FACILITY_ID
FA0027443
FACILITY_NAME
FAB, FREEZE, FUN
STREET_NUMBER
18052
STREET_NAME
CLEMENTINE CRT
City
LATHROP
Zip
95330
CURRENT_STATUS
01
SITE_LOCATION
18052 CLEMENTINE CRT
P_LOCATION
07
QC Status
Approved
Scanner
SJGOV\ymoreno
Tags
EHD - Public
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SAA){I1 O A Q I�I'r A) Environmental Health Department <br /> -- wnl.JN—Y <br /> 7. Delivery Limitation: Initial if you agree to abide by the following: V%W <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 /> I, VY-ysJrt4 agree to grant access to the local health department to <br /> conduct ark inspection of my cottage food operation(mark one) <br /> "Class A":In the event ur 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 /> l }-( (.• l,�r� v+ r ,agree to notify the San Joaquin County Environmental <br /> Health bepartment prior to mdTfifying 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 /> wf s�rl� L �lr�gti,�" to 13O I2T <br /> Owner's ignalure P�inl ,vnc Dale <br /> I <br />
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