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�AN ,,,,oAQUIN Environmental Health Department <br /> F, COUNTY <br /> COTTAGE FOOD OPERATIONS (CFO) <br /> REGISTRATION/PERMITTING FORM <br /> (CALIFORNIA HOMEMADE FOOD ACT AB 1616 (GATTO)) <br /> CFO Business Name: Owner Name: Date: <br /> Pretty Sweet Treats Heather Mayes 05/05/18 <br /> CFO Physical Address: CFO City: CFO Zip: <br /> 1632 Orgullo Lane Manteca 95337 <br /> Website(If applicable): Telephone: <br /> (209)483-5354 <br /> 1. Categories: <br /> "Class A" (Direct Sales Only)$146 ❑ "Class B" (Direct & Indirect Sales)$292 <br /> 2. Prohibited Items: Initial if you agree to abide by the followi g: <br /> ,A41 <br /> Foods containing cream, custard, or meat fillings are potentially hazardous and are NOT ALLOWED. Only <br /> foods that are defined as "non-potentially hazardous" are approved for preparation by a Cottage Food Operation. <br /> These foods include items that do not require refrigeration to keep them safe from bacterial growth that could be a <br /> cause of food-borne illness. <br /> 3. "Class A" Self Certification Checklist: <br /> [� Checklist completed ("Class A"CFOs Only) <br /> 4. Products: <br /> Please check the items you will be preparing and/or selling. <br /> R Baked Goods ❑ Dried Pasta Honey 12 Popcorn/ <br /> Popcorn Balls ' <br /> Ij <br /> [� Candy ❑ Dry Baking Mixes ❑ Mustard ❑ Vinegar k <br /> ❑ Churros [ Waffle Cones ❑ Dried Grain Mixes ❑ Fruit Butter" ' <br /> Buttercream Buttercream Ground <br /> Frosting/Icing* Fondant/Gumpaste* nX Flat Icing ❑ Chocolate <br /> ❑ Dried Mole Paste ❑ Herb/Spice Blends ❑ Pizzeles ❑ Jams/Jellies** <br /> Nut Mixes/Nut <br /> Fried or Baked <br /> ❑ Fruit Empanadas ❑ Fruit Tamales/Pies ❑ gutters ElDonuts and <br /> Waffles <br /> ❑ Granola/Cereals ❑ Seasoning Salt ❑ Trail Mix/ Dried Fruit ❑ Dried Fruit <br /> Salted Marshmallows/ <br /> Cotton Candy [� Candied Apples j� [� Marshmallow j <br /> Caramel/Fudge Bars* <br /> i <br /> Dried or Dehydrated Dried Vegetarian- <br /> ❑ Vegetables ❑ Based Soup Mixes ❑ Vegetable and Potato Chips <br /> l <br /> 1868 E. Hazelton Avenue ( Stockton, California 95205 1 T 209468-34201 F 209464-0138 1 www.sjcehd.com <br /> I <br />