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COMPLIANCE INFO_2024
Environmental Health - Public
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1600 - Food Program
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PR0547731
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COMPLIANCE INFO_2024
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Entry Properties
Last modified
9/18/2024 11:11:22 AM
Creation date
9/10/2024 2:51:00 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2024
RECORD_ID
PR0547731
PE
1609
FACILITY_ID
FA0027185
FACILITY_NAME
CAFECALLI ROASTER
STREET_NUMBER
410
STREET_NAME
PALM
STREET_TYPE
CIR
City
TRACY
Zip
95376
CURRENT_STATUS
01
SITE_LOCATION
410 PALM CIR
P_LOCATION
03
QC Status
Approved
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SJGOV\ymoreno
Tags
EHD - Public
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SAN JOAQUIN <br /> <br />Environmental Health Department <br />COUNTY - <br />7. Delivery Limitation: Initial if you agree to abide by the following: .1FR/I V <br />I understand that I may accept orders and payments via the internet, mail or phone. However, all "Class A" and <br />"Class B" CFO products must be delivered directly (in person) to the customer. The CFO products may not be <br />delivered via the United States Postal Service, UPS, FedEx, or using any other indirect delivery method as <br />deliveries are regulated by, and subject to, CDPH registration and state and federal requirements. <br />Owner's Statement: <br />I, Jose Forique/Lissette , agree to grant access to the local health department to <br />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 inspections <br />complaint or reported food-borne illness and in the event of a consumer complaint or <br />food-borne illness <br />I, Jose Enrique/I issette , agree to notify the San Joaquin County Environmental <br />Health Department prior to modifying my food list, type of operation, and/or method of selling, distributing, or <br />otherwise providing my CFO produ ts to the consumer or retailers, regardless of whether the product is sold, <br />consigned, or given away. <br />Jose Forique Rallarlares 07/1R/2024 <br />Owner's Signature Print Name Date <br />2 of 2
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