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COMPLIANCE INFO_2024
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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1600 - Food Program
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PR0548482
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COMPLIANCE INFO_2024
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Entry Properties
Last modified
6/12/2024 9:54:32 AM
Creation date
6/6/2024 11:03:35 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2024
RECORD_ID
PR0548482
PE
1608
FACILITY_ID
FA0027699
FACILITY_NAME
ROXY SWEET'S
STREET_NUMBER
577
STREET_NAME
LODE
STREET_TYPE
ST
City
MANTECA
Zip
95336
CURRENT_STATUS
01
SITE_LOCATION
577 LODE ST
P_LOCATION
04
QC Status
Approved
Scanner
SJGOV\ymoreno
Tags
EHD - Public
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SA N :: I O A Q I I I N Environmental Health Department <br /> COUNTY <br /> 7. Delivery Limitation: Initial if you agree to abide by the following: R 1 <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, YCkY1C l`�cw�� vee a �n.-)c, 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, -Rnxn r1a Rca,rn'Yec 1 01kelpe agree to notify the San Joaquin County Environmental <br /> Health Department prior to modifying 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 /> nxcay� o vr�i r e z Yjo o� Ian i eZ P:�-,I dS/Z9 Z y <br /> Owner's Signature Print Name Date <br /> 2of2 <br />
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