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COMPLIANCE INFO_2024
Environmental Health - Public
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EHD Program Facility Records by Street Name
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W
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WILLOW
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1111
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1600 - Food Program
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PR2500221
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COMPLIANCE INFO_2024
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Entry Properties
Last modified
6/3/2025 3:35:22 PM
Creation date
6/3/2025 3:34:37 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2024
RECORD_ID
PR2500221
PE
1608 - CLASS A COTTAGE FOOD-DIRECT SALES
FACILITY_ID
FA0002845
FACILITY_NAME
MASA MADRE BREAD
STREET_NUMBER
1111
Direction
W
STREET_NAME
WILLOW
STREET_TYPE
ST
City
STOCKTON
Zip
95203
CURRENT_STATUS
Active
QC Status
Approved
Scanner
SJGOV\ymoreno
Supplemental fields
Site Address
1111 W WILLOW ST STOCKTON 95203
Tags
EHD - Public
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Dried or Dehydrated <br />Vegetables <br />Sweet Sorghum <br />Syrup <br />Fried or Baked <br />Donuts and Waffles <br />Other <br />0 Vegetable and Potato Chips <br />0 Chocolate Covered Nonperishable Food <br />El Dried Hot Chocolate 0 Fruit Infused Balsamic Vinegar <br />El Dried Vegetarian- <br />Based Soup Mixes <br />Roasted Coffee <br />(Beans/Grounds) <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.accessclataida.cioviscripts/cdrhfcfdocsicfCFR/CFRSearch.cfin?CFRPart=150 <br />Food Descriptions: 1ia(1i\itv,41 do ,m. piled et , 9,1)441 ti -d v‘( <br />C14244-rt, Ta-acri , TveRtiA T*Per4 1.2‘kcftA),,sciA \14to <br />Tyiea ww-E-fiv s, dMiiei etts, tigir át(61 4i,____ <br />Oercileil s ) 2> c4 Il , Pergve-4-e__, <br />EHD 16-27 6/29/2023 <br /> 2 CFO REG/PERMI1T1NG FORM
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