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COMPLIANCE INFO_2023
EnvironmentalHealth
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1600 - Food Program
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PR0548721
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COMPLIANCE INFO_2023
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Last modified
11/14/2023 3:10:43 PM
Creation date
11/14/2023 3:09:48 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2023
RECORD_ID
PR0548721
PE
1608
FACILITY_ID
FA0027889
FACILITY_NAME
REDWOOD TEA ESTATE
STREET_NUMBER
5676
STREET_NAME
SUNBURY
STREET_TYPE
RD
City
STOCKTON
Zip
95212
CURRENT_STATUS
01
SITE_LOCATION
5676 SUNBURY RD
P_LOCATION
01
QC Status
Approved
Scanner
SJGOV\ymoreno
Tags
EHD - Public
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Dried or Dehydrated Dried Vegetarian- <br />Vegetables Based Soup Mixes <br />El Sweet Sorghum Roasted Coffee <br />Syrup (Beans/Grounds) <br />EJ Fried or Baked 0 Dried Hot Chocolate Donuts and Waffles <br />Vegetable and Potato Chips <br />1:1 Chocolate Covered Nonperishable Food <br />Fruit Infused Balsamic Vinegar <br />0 Other <br />* Do not contain eggs, cream, or cream cheese <br />** If preparing jams, jellies or fruit butters, include a list of ingredients (attach separate page if needed). These items <br />must comply with standards described in Part 150 of Title 21 of the Code of Federal Regulations <br />http://www.accessdata.fda.qoviscripts/cdrh/cfdocs/cfCFR/CFRSearch.cfm?CFRPart=150 <br />Food Descriptions: on, a,,,,yd,„1,d ItRve,% + c yr,Q., <br />(1Zev;s 13 1 4 ,14--, sold °t1 bithck, 4-e_cA ree -}-tc, oulooy <br />0+1,tr a,ried heAs ore, ,Nme,41nei ok cidedi 1-1,efe re. <br />rnin f-, 1-erkkovN vtritn,A an ECA5t. <br />EHD 16-27 6/29/2023 2 CFO REG/PERMITTING FORM
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