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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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PR0548352
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COMPLIANCE INFO_2023
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Entry Properties
Last modified
4/24/2025 2:29:37 PM
Creation date
4/24/2025 2:28:07 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2023
RECORD_ID
PR0548352
PE
1608 - CLASS A COTTAGE FOOD-DIRECT SALES
FACILITY_ID
FA0027609
FACILITY_NAME
CARTER SIX
STREET_NUMBER
99
Direction
W
STREET_NAME
BRILLOSO
STREET_TYPE
LN
City
MOUNTAIN HOUSE
Zip
95391
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\jcastaneda
Supplemental fields
Site Address
99 W BRILLOSO LN MOUNTAIN HOUSE 95391
Tags
EHD - Public
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9. Employee: <br />Initial if you agree to abide by the following:V <br />I understand that I may not have more than one full-time equivalent cottage food employee, not <br />including a family member or household member of the cottage food operator, working within the <br />registered or permitted area of a private home where the cottage food operator resides and where <br />cottage food products are prepared or packaged for direct, indirect, or direct and indirect sale to <br />consumers. <br />10. Delivery Limitation: Initial if you agree to abide by the following: <br />I understand that I may accept orders and payments via the internet, mail or phone. However, all "Class <br />K and "Class W CFO products must be delivered directly (in person) to the customer. The CFO products <br />may not be delivered via the United States Postal Service, UPS, FedEx, or using any other indirect <br />delivery method as deliveries are regulated by, and subject to, CDPH registration and state and federal <br />requirements. <br />11. Owner's Statement: <br />I, fr I!m F 017,,� agree to grant access to the local health <br />department to 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 <br />` complaint or reported food -borne illness inspections and in the event of a consumer <br />complaint or food-bome <br />I, tl /'Y1# PlnW agree to notify the San Joaquin County <br />Environmental Health Department prior to modifying my food list, type of operation, and/or method <br />of selling, distributing, or otherwise providing my CFO products to the consumer or retailers, <br />regardless of whether the product is sold, consigned, or given away. <br />!m A- 1/3 <br />Date <br />EHD 16-27 6/29/2075 5 CFO REG/PERMrMNG FORM <br />
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