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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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PR0548833
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COMPLIANCE INFO_2023
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Entry Properties
Last modified
12/28/2023 9:26:43 AM
Creation date
12/28/2023 9:26:21 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2023
RECORD_ID
PR0548833
PE
1609
FACILITY_ID
FA0027980
FACILITY_NAME
FREEZE DRIED CANDY FOR ME
STREET_NUMBER
218
STREET_NAME
CHARLES
STREET_TYPE
AVE
City
MANTECA
Zip
95336
CURRENT_STATUS
01
SITE_LOCATION
218 CHARLES AVE
P_LOCATION
04
QC Status
Approved
Scanner
SJGOV\ymoreno
Tags
EHD - Public
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Example: <br />BIG CAKE BAKER <br />Stockton CA 95209 <br />Perm VI 012345 <br />issued in: San Joaquin County <br />Chocolate Chip Cookies with Walnuts <br />Ingredients: Enriched flour 1wheat flow, niacin, reduced iron, thiamine, mononitrate, riboflavin <br />and folic aodi, butter 'milk, salt), chocolate chips 'sugar, chocolate liquor, cocoa butter, butterfat <br />walnuts, sugar.. eggs, salt artificial vanilla cetract, baking soda <br />FreezeDriedCandyForMe <br />litlies <br />Net Wt. 4oz (113.3g) <br />Made In A Home Kitchen <br />Ingredients: Made of Sugar. Corn Syrup.Hydrogenated palm kemal oil, <br />Less than 2% of citnc acid, Tapioca dextrin. Modified corn starch. <br />Natural and artificial flavors, sodium citrate. Colors (Yellow 5 lake <br />Red 40 Lake, Yellow 6 Lake. Blue 1 Lake. Yellow 6. Red 40 <br />Yellow 5, Blue 11 Camauba Wax. Gluten Free. Gelatin Fre <br />)44 - <br />Manteca CA 95336 <br />Permit# 'Pending* <br />Issued in: San Joaquin County <br />Note: For the 'issued in County" - Identify the jurisdiction (city/county) where you are obtaining approval. <br />Disposal of Waste: <br />Please check what type of treatment is used to dispose of waste <br />I1Public Sewer Service ID Private Septic System <br />In the event of septic system failure or plumbing problem, you are required to notify San Joaquin County Environmental Health <br />Department immediately. <br />Water Source: <br />Pease Identify the water source to be used in Cottage Food Facility (check one box) <br />E. Name of Public Water System or Community Services District: eft CA kktiff_ 0 Private Water Supply**, Identify the source (well, spring, surface, etc.). <br />Private Water Supply: Initial Water Quality Results <br />Check boxes below if initial water testing has been completed. <br />All testing must be done at a State Certified Laboratory. Either attach lab results or provide name of lab, date & <br />results in space provided next to type of test. <br />*(Testing frequency for transient Non-Community Water Systems after initial testing) <br />E] Bacteriological Test (quarterly*): <br />El Nitrate Test (yearly*): <br />END 16-27 6/29/2023 4 CFO REG/PERMITTING FORM
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