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COMPLIANCE INFO_2022
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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PR0538142
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COMPLIANCE INFO_2022
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Last modified
12/21/2022 2:54:17 PM
Creation date
3/31/2022 3:34:40 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2022
RECORD_ID
PR0538142
PE
1609
FACILITY_ID
FA0022030
FACILITY_NAME
BAKED BY MRS K
STREET_NUMBER
864
STREET_NAME
GOTLAND
STREET_TYPE
CT
City
TRACY
Zip
95376
APN
20938047
CURRENT_STATUS
01
SITE_LOCATION
864 GOTLAND CT
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
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SJGOV\jcastaneda
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EHD - Public
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SAN I O fi Q U I N Environmental Health Department <br /> _-C O It N„Y ------- <br /> ❑ Dried or Dehydrated ❑ Dried Vegetarian- ❑ Vegetable and Potato Chips <br /> Vegetables Based Soup Mixes <br /> Sweet Sorghum Roasted Coffee <br /> El Syrup ❑ (Beans/Grounds) ElChocolate Covered Nonperishable Food <br /> Fried or Baked <br /> El Donuts and WafflesElDried Hot Chocolate ElFruit Infused Balsamic Vinegar <br /> ❑ Other <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 http�//www.accessdata.fda.gov/scripts/cdrh/cfdocs/CfCFR/CFRSearch.cfm?CFRPart=150 <br /> Food Descriptions: <br /> 2of5 <br />
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