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COMPLIANCE INFO_2022
Environmental Health - Public
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1600 - Food Program
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PR0547399
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COMPLIANCE INFO_2022
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Entry Properties
Last modified
3/3/2022 11:56:53 AM
Creation date
3/1/2022 1:24:22 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2022
RECORD_ID
PR0547399
PE
1608
FACILITY_ID
FA0026945
FACILITY_NAME
MELO BREAD
STREET_NUMBER
801
STREET_NAME
WILLIAMSON
STREET_TYPE
RD
City
MANTECA
Zip
95337
CURRENT_STATUS
01
SITE_LOCATION
801 WILLIAMSON RD
P_LOCATION
04
QC Status
Approved
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SJGOV\jcastaneda
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EHD - Public
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SAN _J OAQ U I N Environmental Health Department <br /> —COUNTY— <br /> Sweet Sorghum Roasted Coffee <br /> ❑ Syrup El (Beans/Grounds) ❑ Chocolate Covered Nonperishable Food <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://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfCFR/CFRSearch.cfm?CFRPart=150 <br /> Food Descriptions: <br /> 4+vN1� L�g� •. T$S Ftsvrl t 1�11bh NouMI�►N �I,o.,ri f RwrE25t �Swlagt hlK1E�t SaL'( <br /> (�F� I.oRF:l`6S Floua , `'11611 U('rf NwlW f n , 1R>f,�7E25E (tS SIS Wk? - . SA-q <br /> Rtwt�ktN SEU51 Sumft'wbm Sriws , flax sass , Y16aL*, CeWKEn atVq( <br /> 4r>,41 UT- CV2AN[3gVt4/ LOAF: SAME /'t5 `ow"712, 2014 p + WALNUTS /1140 IDY11E19 <br /> BC2+2y a4iwl : RAIP13FARICS f JV6RY1 , Ch%A SEEn$ <br /> NU-0LACIE -kA'IauNIi SfJQCAP: VAUL.NI5. (Ar" R-v—P 1 %r'*t2I S.-ra <br /> l 94311 (f�R aoD�kc, I �wtrM SelLrs l.C. Cv NNAMON SAS'( <br /> ChbtatATG - HA-1151N17r SP'1126AV: hAZ&L&VT3 r 5U6AW f CACAO / SkLr CI1vNA✓17vv <br /> ALrAONV BUTIM A LK10/vrls / S A-6T <br /> 2 of <br /> EHD 16-27 6/29/17 CFO REG/PERMr TING FORM <br />
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