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COMPLIANCE INFO_2023
Environmental Health - Public
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1600 - Food Program
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PR0548749
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COMPLIANCE INFO_2023
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Last modified
11/15/2023 4:36:27 PM
Creation date
11/8/2023 11:44:57 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2023
RECORD_ID
PR0548749
PE
1608
FACILITY_ID
FA0027912
FACILITY_NAME
BLUSH BAKERY
STREET_NUMBER
2237
STREET_NAME
CANARD
STREET_TYPE
PL
City
MANTECA
Zip
95337
CURRENT_STATUS
01
SITE_LOCATION
2237 CANARD PL
P_LOCATION
04
QC Status
Approved
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SJGOV\ymoreno
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EHD - Public
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9. Employee: Initial if you agree to abide by the following: <br /> I understand that I may not have more than one full-time equivalent cottage food employee, not <br /> including a family member or household member of the cottage food operator,working within the <br /> registered or permitted area of a private home where the cottage food operator resides and where <br /> cottage food products are prepared or packaged for direct, indirect,or direct and indirect sale to <br /> consumers. <br /> 10.Delivery Limitation: Initial if you agree to abide by the following: `fes <br /> I understand that I may accept orders and payments via the internet,mail or phone. Direct and <br /> Indirect sales may be fulfilled in person,via mail delivery,or using any other third-party delivery <br /> service throughout the state of California only. <br /> 11. Owner's Statement: <br /> I, rn U 1a 7U ry agree to grant access to the local health <br /> department to conduct an inspection of my cottage food operation(mark one) <br /> ,Class A": In the event of a consumer ❑ "Class B": For regular annual facility <br /> complaint or reported food-borne illness inspections and in the event of a consumer <br /> complaint or food-borne <br /> I, 1/ agree to notify the San Joaquin County <br /> Environmental Health Department prior to modifying my food list,type of operation, and/or method <br /> of selling, distributing,or otherwise providing my CFO products to the consumer or retailers, <br /> regardless of whether the product is sold,consigned, or given away. <br /> (a- ' � ACte 10lu).13 <br /> Owner's Sig—We Print Name Date <br /> EHD 16-27 6/29/2023 5 CFO REG/PERMITTING FORM <br />
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