Laserfiche WebLink
r <br /> S Q N O Q Q U N Environmental Health Department <br /> COUNTY <br /> 0 <br /> cqh�0, Greatness grows here. <br /> COTTAGE FOOD OPERATIONS (CFO) <br /> REGISTRATIOWPERMITTING FORM <br /> (CALIFORNIA HOMEMADE FOOD ACT AB 1616 (GATTO)) <br /> CFO Business Name: <br /> Owner Name: Date: <br /> &I'ke f� U F n<W4,J KRO-h W" <br /> CFO Zip:FO City: <br /> CFO Physical Address: C 7 (1' <br /> 6-,116 C �,e in n T`CGl L' I <br /> Website(if applicable): Telephone. y <br /> 1. Categories: <br /> "Class A" (Direct Sales Only) $155 ❑ "Class B" (Direct& Indirect Sales) $310 <br /> agree to abide by the following: <br /> Initial if you a <br /> 2. Prohibited Items: Y 9 <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 /> Popcorn/ <br /> Baked Goods F-1DriedPasta ❑ Honey ❑ Popcorn Balls <br /> ❑ Candy ❑ Dry Baking Mixes ❑ Mustard ❑ Vinegar <br /> ❑ Churros ❑ Waffle Cones ❑ Dried Grain Mixes ❑ Fruit Butter" <br /> ❑ <br /> Buttercream Buttercream Ground E] Flat Icing ❑ Chocolate <br /> Frosting/Icing' ❑ Fondant/G um paste* <br /> ❑ Dried Mole Paste ❑ Herb/Spice Blends ❑ Pizzeles ❑ Jams/Jellies** <br /> Fried or Baked <br /> F] Fruit Empanadas ❑ Fruit Tamales/Pies ElNut Mixes/Nut El Donuts andButters <br /> Waffles <br /> ❑ Granola/Cereals ❑ Seasoning Salt ❑ Trail Mix/Dried Fruit ❑ Dried Fruit <br /> Marshmallows/ <br /> F-1Cotton Candy ElCandied Apples ElSalted Marshmallow <br /> Caramel/Fudge ❑ Bars* <br /> ❑ Dried or Dehydrated ❑ Dried Vegetarian- ❑ Vegetable and Potato Chips <br /> Vegetables Based Soup Mixes <br /> 1868 E. Hazelton Avenue 1 Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />