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COMPLIANCE INFO_2023
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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1600 - Food Program
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PR0537673
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COMPLIANCE INFO_2023
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Last modified
3/22/2023 9:55:06 AM
Creation date
3/22/2023 9:54:18 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2023
RECORD_ID
PR0537673
PE
1608
FACILITY_ID
FA0021706
FACILITY_NAME
CHANEL NIE CAKES
STREET_NUMBER
16775
STREET_NAME
FORTY NINER
STREET_TYPE
TR
City
LATHROP
Zip
95330
APN
19137051
CURRENT_STATUS
01
SITE_LOCATION
16775 FORTY NINER TR
P_LOCATION
07
P_DISTRICT
003
QC Status
Approved
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SJGOV\jcastaneda
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EHD - Public
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d. Food Processor Course: <br />Attach food handler certification for owner and each individual that were not submitted with Initial <br />application (including family members and/or employees). <br />7. Delivery Limitation: Initial if you agree to abide by the following; t �� <br />I understand that I may accept orders and payments via the internet, mail or phone, However, all "C {aL <br />A" and "Class B" CFO products must be delivered directly (in person) to the customer. The CFO products <br />may not be delivered via the United States Postal Service, UPS, FedEx, or using any other indirect <br />delivery method as deliveries are regulated by, and subject to, CDPH registration and state and federal <br />requirements. <br />S. Owner's Statement: <br />agree to grant access to the local health <br />n of my cottage food operation (mark one) <br />department to conduct an inspectio <br />® "Class A": In the event of a consumer <br />complaint or reported food -borne illness <br />❑ "Class B": For regular annual facility inspections <br />and in the event of a consumer complaint or <br />food -borne illness <br />1, N oIL S�� S , agree to notify the San Joaquin County <br />Environmental Health Department prior to modifying my food list, type of operation, and/or method <br />of selling, distributing, or otherwise providing my CFO products to the consumer or retailers, <br />regardless of whether the product is sold, consigned, or given away. <br />A_ <br />Owner's Signature <br />4 (eI Sher Mai. <br />Print Name <br />-�I(il,) <br />
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