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** This is a non-4200/4300/2600 Program Code, you must select a File Section
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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V
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VALPICO
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351
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1600 - Food Program
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PR0547567
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** This is a non-4200/4300/2600 Program Code, you must select a File Section
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Entry Properties
Last modified
6/13/2023 1:02:23 PM
Creation date
6/13/2023 12:41:05 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
RECORD_ID
PR0547567
PE
1608
FACILITY_ID
FA0027060
FACILITY_NAME
ASH BLOSSOM BAKERY
STREET_NUMBER
351
Direction
E
STREET_NAME
VALPICO
STREET_TYPE
RD
City
TRACY
Zip
95376
CURRENT_STATUS
01
SITE_LOCATION
351 E VALPICO RD APT 1016
P_LOCATION
03
QC Status
Approved
Scanner
SJGOV\ymoreno
Tags
EHD - Public
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SAN JOAQUIN <br /> <br />Environmental Health Department <br />COUNT\,' <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 />Owner's Statement: <br /> ,agree to grant access to the local health department to <br />conduct an insp.'ettion of my cottage food operation (mark one) <br />4 "Class A": In the event of a consumer LII "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 />00 ,agree to notify the San Joaquin County Environmental <br />Health Departmeht 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 />_ 44, <br />Owner's Signature <br />-,--) - <br />rocie 2,7 <br />Print Naffie ate <br /> <br />2 of 2
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