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COMPLIANCE INFO_2025
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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ANTIGUA TERR
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1600 - Food Program
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PR2500310
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COMPLIANCE INFO_2025
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Entry Properties
Last modified
3/12/2026 1:06:50 PM
Creation date
3/12/2026 12:47:10 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2025
RECORD_ID
PR2500310
PE
1609 - CLASS B COTTAGE FOOD-INDIRECT SALES
FACILITY_ID
FA0003264
FACILITY_NAME
PALMYRA SWEET
STREET_NUMBER
772
STREET_NAME
ANTIGUA TERR
City
MOUNTAIN HOUSE
Zip
95391
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\ymoreno
Supplemental fields
Site Address
772 W ANTIGUA TER MOUNTAIN HOUSE 95391
Tags
EHD - Public
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❑ Dried or Dehydrated ❑ Dried Vegetarian- ❑ Vegetable and Potato Chips <br /> Vegetables Based Soup Mixes <br /> Sweet Sorghum Roasted Coffee <br /> Syrup 171, (Beans/Grounds) ® Chocolate Covered Nonperishable Food <br /> Fried or Baked <br /> ❑ Donuts and Waffles ElDried Hot Chocolate ElFruit Infused Balsamic Vinegar <br /> Other Dates filled with nuts and covered with chocolate <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.goviscriptsicdrhlcfdocslcfCFR/CFRSearch.ofm?C FRPart=150 <br /> Food Descriptions: <br /> Plump, naturally swept dates PnvPlolapd in A verity of crunrhV nuts, each offering a <br /> unique flavor and texture. From the buttery richness of almonds to the earthy warmth <br /> of walnuts and the delicate nuttiness of pistachios. Every bite offers a unique and <br /> harmonious blend of sweetness and crunch. These chocolate covered dates with nutty <br /> center makes wholesome and satisfying treat that's both nutritious and indulgent. <br /> EHD 16-27 6129/2023 2 CFO REGIPERMITTING FORM <br />
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