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COMPLIANCE INFO
Environmental Health - Public
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EHD Program Facility Records by Street Name
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SIERRA MADRE
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70
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1600 - Food Program
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PR0543863
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COMPLIANCE INFO
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Last modified
2/5/2021 4:24:06 PM
Creation date
2/5/2021 4:23:10 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0543863
PE
1609
FACILITY_ID
FA0024941
FACILITY_NAME
MELT
STREET_NUMBER
70
Direction
N
STREET_NAME
SIERRA MADRE
STREET_TYPE
ST
City
MOUNTAIN HOUSE
Zip
95391
CURRENT_STATUS
01
SITE_LOCATION
70 N SIERRA MADRE ST
P_LOCATION
99
QC Status
Approved
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SJGOV\jcastaneda
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EHD - Public
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' S A N sJ O A Q U I N Environmental Health Department <br /> —COUNTY- <br /> 7. 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 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 /S, Ltatement: // <br /> I,;Jah t-u ��7 NMw% agree to grant access to the local health department to <br /> conduct an inspection 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, ,. d4a//ILC/�( tT� � 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 /> it!a 4qir� <br /> OWnef S g ure Print Name Date <br /> 2 of <br />
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