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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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PR0546820
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COMPLIANCE INFO_2023
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Entry Properties
Last modified
5/9/2023 4:20:26 PM
Creation date
5/9/2023 4:15:23 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2023
RECORD_ID
PR0546820
PE
1608
FACILITY_ID
FA0026516
FACILITY_NAME
WAHL TO WAHL CONFECTION'S
STREET_NUMBER
1620
STREET_NAME
CORBIN
STREET_TYPE
LN
City
LODI
Zip
95242
CURRENT_STATUS
01
SITE_LOCATION
1620 CORBIN LN
P_LOCATION
02
QC Status
Approved
Scanner
SJGOV\ymoreno
Tags
EHD - Public
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SAN JOAQUIN cou N T <br />Environmental Health Department <br />Employee: Initial if you agree to abide by the following: /41, II <br />I understand that I may not have more than one full-time equivalent cottage food employee, not including a <br />family member or household member of the cottage food operator, working within the registered or permitted <br />area of a private home where the cottage food operator resides and where cottage food products are prepared <br />or packaged for direct, indirect, or direct and indirect sale to consumers. <br />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 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 />Owner's Statement: <br />I, 4111 4' \A, 0 1 , agree to grant access to the local health department to <br />conduct an inspection of my cottage food operation (mark one) <br />17 "Class A": In the event of a consumer <br />complaint or reported food-borne illness <br />"Class B": For regular annual facility <br />inspections and in the event of a consumer <br />complaint or food-borne <br />O 1/1k)&1- %Loll , 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 />2 -7 /2 <br />wner's Signature Print Name bate <br />lbe-r- \I' 1i <br />5 of 5
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