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SAN JOAOUIN Environmental Health Department <br /> NTY <br /> COTTAGE FOOD OPERATIONS (CFO) <br /> REGISTRATION/PERMITTING RENEWAL FORM <br /> Cf0 Durrin:st r.� Nim <br /> T!u wevtt, `Scp�r r C God es : te d;: .2 <br /> Csn <br /> t. Cateciaries: '4J LJ <br /> 't:laf:s A'tUuctit Sekra Unly)31 5 Ej 'Class B'(Direct&lndlreCt Sefe9)5310 <br /> 2. Prohibited Items: Initial if you agree to abide by the following: <br /> Foods containing cream,custard,ex meat fillings arc potentially hatanfous an-u z!r_ NO ALLOWED U'ly <br /> foods that oro defined as'non-potentially hazardous'arc StDroved for preparation by a cotta;,, Fcord operation <br /> These foods include iturns that do not requue rd'hgeration to keep them safe from bacterial grovAh MW.could be a <br /> cause of lour!-borne 111m Uri <br /> 3. Products: <br /> ^1 al products you are prorarong If preparing tams,11801es, or fruit butters include a list tri <br /> it r3d.=-rat i-art sepanfftf!pages rf�neededi <br /> Food List. f'G��` /$-`7'I G- �_LCA�J <br /> 4. Product Labeling <br /> ---__; t•.vo labels :_ farm for tufo of yAUr CFF prDdUCts(only One label is required if oriry one product m- <br /> 5. Water Source: <br /> Fzi tl,c c^hcc*vmar My cf wWor mimv is being meed at the(70- <br /> &City Wafer ❑Pfrvato Weil. <br /> `U a private well,atb=h an updated waleir sample results j!nlduding clwvto-�ly bacteria and Nctrate rosutis j <br /> 6. Food Processor Course: <br /> Anon food hanQitr cerbficabon for owner and each indraidual that were not submitted wits i i?i[ial application <br /> (inciu6ng family mcmWe and/o(omooyces) <br /> 1&W E.Hacalfon Amore I Stotirton.Caafomin 95205 I T 209 468 34201 F 209 464 0138 1 www&JceM horn <br />