Laserfiche WebLink
'x; SAKdOAQUIN Environmental Health Department <br /> ! —COUNTY— <br /> Greatness grows here. - <br /> COTTAGE FOOD OPERATIONS (CFO) <br /> REGISTRATION/PERMITTING FORM <br /> (CALIFORNIA HOMEMADE FOOD ACT AB 1616.(GATTO)) <br /> CFO Business Name: Owner Na e: ale: <br /> V616a el rFoie �iirrns��a� f'j'1►�l� ►�v6 <br /> CFO Physical Address: CFO City: CFO Zip: <br /> cam_ ✓a�n (� i r �'�c l�j-� n CIS]71 <br /> Websi)e(If a plicable: elephone: <br /> 1m ,, IVla 6V,,0nA AS le, . Gom ?a�� <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 /> F1Baked Goods ❑ Dried Pasta ❑ Honey ElPopcorn/ <br /> —,/Popcorn Balls <br /> F-1Candy ❑ Dry Baking Mixes ElEa Mustard Vinegar <br /> ❑ Churros El' Waffle•Cones' i. ❑ Dried Grain Mixes ❑ ,Fruit Butter" - <br /> ❑ Buttercream ❑ Buttercream ❑ Flat Icing ❑ Ground <br /> Frosting/Icing' Fondant/Gumpaste* Chocolate <br /> ❑ Dried Mole Paste Fkr Herb/Spice Blends ❑ Pizzeles ❑ Jams/Jellies" <br /> Nut Mixes/Nut Fried or Baked <br /> ❑ Fruit Empanadas ❑ Fruit Tamales/Pies ❑ gutters ❑ Donuts and - <br /> Waffles <br /> ❑ Granola/Cereals 01 Seasoning Salt ❑ Trail Mix/ Dried Fruit ❑ Dried Fruit <br /> Salted Marshmallows/ <br /> ❑ Cotton Candy ❑ Candied Apples ❑ Caramel/Fudge El Marshmallow <br /> Bars` <br /> ❑ Dried or Dehydrated ❑ Dried Vegetarian- ❑ Vegetable and Potato Chips <br /> Vegetables Based Soup Mixes <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/EHD <br />