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SAN J O A Q U I N Environmental Health Department <br />�•:f COUNTY— Rlecg7�Nr <br />`4<>� Greatness grows here. <br />COTTAGE FOOD OPERATIONS (CFO) MAY Z 1 2019 <br />em <br />REGISTRATION/PERMITTING FORM ENv;R°NMErvrqL <br />(CALIFORNIA HOMEMADE FOOD ACT AB 1616 (GATTO)) PER''I�IIT�S R</,HSs <br />CFO Business Name: Owner Name: Date: <br />NEW HARVEST CLAUDIA RENTERIA 5/6/2019 <br />CFO Physical Address: CFO City: CFO Zip: <br />1437 S ANTEROS AV STOCKTON CA 95215 <br />Website (If applicable): Telephone - <br />(209)688 -7408 <br />1. Categories: <br />❑ "Class A" (Direct Sales Only) $155 "Class B" (Direct & Indirect Sales) $310 <br />2. Prohibited Items: Initial if you agree to abide by the following: <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 />❑ Baked Goods <br />❑ Candy <br />❑ Churros <br />❑ Buttercream <br />Frosting/Icing" <br />❑ Dried Mole Paste <br />❑ Fruit Empanadas <br />❑ Granola/Cereals <br />❑ Cotton Candy <br />❑ Dried Pasta <br />❑ Dry Baking Mixes <br />❑ Waffle Cones <br />❑ Buttercream <br />Fondant/Gumpaste* <br />❑ Herb/Spice Blends <br />❑ Fruit Tamales/Pies <br />❑ Seasoning Salt <br />❑ Candied Apples <br />❑ Dried or Dehydrated ❑ Dried Vegetarian - <br />Vegetables Based Soup Mixes <br />IV <br />Honey <br />❑ <br />Popcorn/ <br />Popcorn Balls <br />❑ <br />Mustard <br />❑ <br />Vinegar <br />❑ <br />Dried Grain Mixes <br />❑ <br />Fruit Butter" <br />❑ <br />Flat Icing <br />1:1GroundChocolate <br />❑ <br />Pizzeles <br />❑ <br />Jams/Jellies** <br />Fried or Baked <br />❑ <br />Nut Mixes/Nut <br />[:1Butters <br />Donuts and <br />Waffles <br />❑ <br />Trail Mix/ Dried Fruit <br />❑ <br />Dried Fruit <br />Marshmallows/ <br />ElElSalted <br />Marshmallow <br />Caramel/Fudge <br />Bars <br />❑ Vegetable and Potato Chips <br />1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-34201 F 209 464-0138 1 www.sjcehd.com <br />