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�^x^ <br /> � 8N | 08 U | N �����^���00����U ����U�� ���K��»������ <br /> ���� /��� x���Wuo �v °- ^ ~~^ ^ ^ ^~^^ ~~ � ` � ^ <br /> 'p �| <br /> ---C{}i] NTY---' <br /> G,eom��' <br /> COTTAGE FOOD OPERATIONS (CFO) <br /> REGiSTRATIylN/pERMUTTI NG RENEWAL FORM <br /> XJT[u Owner fw* <br /> CFO P ical Address* CFO City: CFO Zip: <br /> qKubw "w owlyff <br /> 11. Categories: <br /> Class A" (Direct Sales Only)$155 "Class B" (Direct& Indirect Sales)$310 <br /> 2. Initial /ryou agree ooabide nythe following: o <br /> Foods containing ureano, cumtard, or meat fillings are potentially hazardous and are NOT ALLOWED. Only <br /> foods that are defined ao ^non-pohentia||yhazardous" are approved for preparation by Cottage Food Operation. <br /> These foods include items that do not require refrigeration to keep them safe from bacterial growth that could be o <br /> cause offood-borne illness. <br /> 3. <br /> Provide a list of all products you are preparing. |fpreparing jams,jellies, or fruit butters include e list of <br /> ingredients (attach separate page if needed). <br /> Food List: <br /> toad <br /> Product Labeling: <br /> .. <br /> Attach two labels tuthis form for two ofyour CFO products (only one label isrequired ifonly one product is <br /> made). <br /> -' <br /> Water Source: <br /> vtase check what type ofwater source isbeing used atthe CFO: <br /> IF ity Water F] Private Well* <br /> °|fa private well, attach all updated water sample veouKo (including quarterly bacteria and Nitrate results.) <br /> -^ <br /> Food Processor Course: <br /> Attach food handler certification for owner and each individual that were not submitted with initial application <br /> (including family members and/or omp|oynoa). <br /> 1868 E. H$ze|ton Avenue I Stomkton, California 95205 1 T 2O0408-342O 1 F 2O&464-0138 1 wvmw.sjmand.num <br />