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COMPLIANCE INFO_2023
Environmental Health - Public
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EHD Program Facility Records by Street Name
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HUTCHINS
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1600 - Food Program
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PR0548652
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COMPLIANCE INFO_2023
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Entry Properties
Last modified
11/15/2023 5:54:44 PM
Creation date
10/10/2023 9:25:59 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2023
RECORD_ID
PR0548652
PE
1608
FACILITY_ID
FA0027836
FACILITY_NAME
THE KOEKSISTER CO.
STREET_NUMBER
738
Direction
S
STREET_NAME
HUTCHINS
STREET_TYPE
ST
City
LODI
Zip
95240
CURRENT_STATUS
01
SITE_LOCATION
738 S HUTCHINS ST
P_LOCATION
02
QC Status
Approved
Scanner
SJGOV\ymoreno
Tags
EHD - Public
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❑ Dried or Dehydrated ❑ Dried Vegetarian- ❑ Vegetable and Potato Chips <br /> Vegetables Based Soup Mixes <br /> Sweet Sorghum Roasted Coffee <br /> ❑ Syrup ❑ (Beans/Grounds) ❑ Chocolate Covered Nonperishable Food <br /> Fried or Baked <br /> Donuts and Waffled ❑ Dried Hot Chocolate ❑ Fruit Infused Balsamic Vinegar <br /> ❑ Other. USe� <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 Regulations <br /> http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfCFR/CFRSearch.cfm?CFRPart-150 <br /> Food Descriptions: <br /> �Gtksl }e( iSCA +rq i-t i on a cu El.Gun ALn koner) <br /> cn c�'Ilo e i d i 0 <br /> rorh <br /> EHD 16-27 6/129/2023 2 CFO REG/PERMITTING FORM <br />
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