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COMPLIANCE INFO_2023
EnvironmentalHealth
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BEARDSLEY
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1600 - Food Program
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PR0546114
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COMPLIANCE INFO_2023
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Entry Properties
Last modified
10/24/2023 12:52:41 PM
Creation date
9/28/2023 4:20:34 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2023
RECORD_ID
PR0546114
PE
1609
FACILITY_ID
FA0026080
FACILITY_NAME
A GREEN ZONE C
STREET_NUMBER
2356
STREET_NAME
BEARDSLEY
STREET_TYPE
AVE
City
MANTECA
Zip
95337
CURRENT_STATUS
01
SITE_LOCATION
2356 BEARDSLEY AVE
P_LOCATION
04
QC Status
Approved
Scanner
SJGOV\ymoreno
Tags
EHD - Public
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SA fl J O A H 1 N Environmental Health Department <br /> _..,-H--iC1 QtJ FNiT Y.._I_._. <br /> 7. Delivery Limitation: Initial if you agree to abide by the following: �(. i... <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,t .o^t cr>I �(f'> t I r`-1'09 '" Sa`i 6,0' agree to grant access to the local health department to <br /> 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 inspections <br /> complaint or reported food-borne illness and in the event of a consumer complaint or <br /> food-borne illness <br /> I, C Avc ro, � t3 w� - h- , agree to notify the San Joaquin County Environmental <br /> Health Department prior to modi ing 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 /> ! ----- L4SAP!�wN ,- A.�,�., �tW-"c <br /> Owner's Signature Print Name Date <br /> 2 of 2 <br />
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