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COMPLIANCE INFO_2021
Environmental Health - Public
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EHD Program Facility Records by Street Name
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1600 - Food Program
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PR0546376
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COMPLIANCE INFO_2021
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Entry Properties
Last modified
1/8/2021 3:55:43 PM
Creation date
1/8/2021 3:52:09 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0546376
PE
1609
FACILITY_ID
FA0026283
FACILITY_NAME
SMITHS TREATS
STREET_NUMBER
16701
STREET_NAME
FOX
STREET_TYPE
RD
City
LODI
Zip
95240
CURRENT_STATUS
01
SITE_LOCATION
16701 FOX RD
QC Status
Approved
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SJGOV\jcastaneda
Tags
EHD - Public
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1-7-fiou-2020 16:25 Private And Confidential. From:2093679996 p.3 <br /> C RRJ('1 A Q I !j N Environmental Health Department <br /> --C n U N T Y...---- <br /> ❑ Sweet Sorghum ❑ Roasted Coffee Chocolate Covered Nonperishable Food <br /> Syrup (Beans/Grounds) <br /> ❑ Fried or Baked ❑ Dried Hot Chocolate ❑ Other <br /> Donuts and Waffles <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 htto:/NAvw.ac4Dessdate.fda.gov/scdt)ls/cdrh/cfdocsfdCFR/CFRSe rchcfm'!CFRPart=150 <br /> Food Descriptions: <br /> r.C}S�7 A ser f CMS t <br /> as?-f mks CAS j OVAL <br /> �tz-���c�•�..f ���t icy� G���:.)�"�S <br /> 2ol5 <br /> EHD 16-27 6/NW CFO REGIPERMITTING FORM <br /> Received Tlme Nov. 11, 2020 3 : 19PM No. 6468 <br />
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