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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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V
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VINE
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101
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1600 - Food Program
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PR0547584
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COMPLIANCE INFO_2022
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Entry Properties
Last modified
4/5/2022 3:30:30 PM
Creation date
4/5/2022 3:28:34 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2022
RECORD_ID
PR0547584
PE
1608
FACILITY_ID
FA0027075
FACILITY_NAME
DOUGHLICIOUS DESSERTS BY RUBY
STREET_NUMBER
101
Direction
W
STREET_NAME
VINE
STREET_TYPE
ST
City
LODI
Zip
95240
CURRENT_STATUS
01
SITE_LOCATION
101 W VINE ST
P_LOCATION
02
QC Status
Approved
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SJGOV\jcastaneda
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EHD - Public
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SANAAQUIN <br />—COUNTY <br />❑ Sweet Sorghum <br />syrup <br />E] Donuts <br />or Baked <br />Donuts and Waffles <br />E] Roasted Coffee <br />(Beans/Grounds) <br />® Dried Hot Chocolate <br />Environmental Health Department <br />K Chocolate Covered Nonperishable Food <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 />li <br />Food Descriptions: <br />CKoc-a II CLt�ech1;> coo1�,P� <br />Q�- v o wtty 1 v t Z 1 wol <br />t,lt( <br />2 of <br />EHD 16-27 6/29117 CFO REGIPERMITTING FORM <br />
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