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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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PR0548662
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COMPLIANCE INFO_2023
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Entry Properties
Last modified
9/15/2023 10:34:34 AM
Creation date
9/13/2023 3:26:38 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2023
RECORD_ID
PR0548662
PE
1609
FACILITY_ID
FA0027844
FACILITY_NAME
HONEY ROCK BOTANICALS
STREET_NUMBER
1021
Direction
S
STREET_NAME
MILLS
STREET_TYPE
AVE
City
LODI
Zip
95242
CURRENT_STATUS
01
SITE_LOCATION
1021 S MILLS AVE
P_LOCATION
02
QC Status
Approved
Scanner
SJGOV\jcastaneda
Tags
EHD - Public
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9. Employee: Initial if you agree to abide by the following: X <br /> I understand that I may not have more than one full-time equivalent cottage food employee, not <br /> including a family member or household member of the cottage food operator, working within the <br /> registered or permitted area of a private home where the cottage food operator resides and where <br /> cottage food products are prepared or packaged for direct, indirect, or direct and indirect sale to <br /> consumers. <br /> 10. Delivery Limitation: Initial if you agree to abide by the following: _ �V <br /> I understand that I may accept orders and payments via the internet, mail or phone. However, all "Class <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 /> 11. Owner's Statement: <br /> I, XWE V/cb" agree to grant access to the local health <br /> department to conduct an inspection of my cottage food operation (mark one) <br /> ❑ "Class A": In the event of a consumer "Class B": For regular annual facility <br /> complaint or reported food-borne illness inspections and in the event of a consumer <br /> complaint or food-borne <br /> I, "Kuk Vick-91511 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 /> Owners Signat a Print Name Date <br /> EHD 16-27 6/29/2023 5 CFO REG/PERMITTING FORM <br />
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