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COMPLIANCE INFO_2023
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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PELTIER
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1600 - Food Program
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PR0548849
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COMPLIANCE INFO_2023
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Entry Properties
Last modified
1/16/2024 11:09:43 AM
Creation date
1/16/2024 11:09:14 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2023
RECORD_ID
PR0548849
PE
1608
FACILITY_ID
FA0027993
FACILITY_NAME
JACALYN SOUTHER
STREET_NUMBER
9355
Direction
E
STREET_NAME
PELTIER
STREET_TYPE
RD
City
ACAMPO
Zip
95220
CURRENT_STATUS
01
SITE_LOCATION
9355 E PELTIER RD
QC Status
Approved
Scanner
SJGOV\ymoreno
Tags
EHD - Public
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SAN 10AdUIN <br />--COUNTY <br />Dried or Dehydrated <br />L_I Vegetables <br />Sweet Sorghum <br />Syrup <br />Fried or Baked <br />Donuts and Waffles <br />Environmental Health Department <br />EJ Vegetable and Potato Chips <br />El Chocolate Covered Nonperishable Food <br />Dried Hot Chocolate El Fruit Infused Balsamic Vinegar <br />Dried Vegetarian- <br />Based Soup Mixes <br />Roasted Coffee <br />(Beans/Grounds) <br />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 <br />Regulations http://www.accessdata.fda.coviscripts/cdrh/cfdocs/cfCFR/CFRSearch.cfm?CFRPart=150 <br />Food Descriptions: <br />pre 9Si?CA I 00 6/' irk/ &irk Wt <br />hLAA VDe A 4+0-c <br />rtd) S4i(e UIeJh (AA-s7 ec c".(-ki-- <br />VeristV 4-60 CAlk -- , hone_t 1 <br />nlp 1,-;,.c 6 yi -1/111* 0164-e, vtid f7t C(+5 (0Cafirk vt6.s_Pyt vuk-thito_l , <br /> <br />1 per per; c 4.±) n ( es. <br />0 es oreA V\I ruci- 5 <br />5t0-ed tA50-r-Vijedatki--se detW suer, c e,56 ;At Sri, <br />txKlx. . vVo,L)./ALL,6,1 cyd -)C• ,011114.zilm ,c--ad-fra <br />Rtf-;,Zelryi fl)-- IA1141.1,4 ro (24, ,IDNOVzcSDA_ Sal; "444 pv_pg <br />C-ktt. Al 111:d-5 0.6 vuL rayVe._) JAI khtil <br />-44.1 6\ <br />,6___ . Wed vta45, r-i racka_ s6 ur-c_ (fed!ili I il ct_cs41 flecb t rve)evr/ .9t(CLe <br />--S44-5(1--ri eActri iL it?(3-v•ickiz rl srSi9-, Ketoit; cui ni.,,,), mix& syiv <br />vtiol-atJ- nil cçQj ),.- sal- <br />D _a, bietei, _ d, , # <br />e .p pe_r - VilitiLu_ caste siAffri, &ally; pejo ak-er sc(),-- ioit_hu: it , alen tt.e_ <br />i 1 <br />Jç <br />2 of 5
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