Laserfiche WebLink
SAN_10AQUIN Environmental Health Department <br /> COUNTY 9 <br /> Greatness rows here. <br /> COTTAGE FOOD OPERATIONS (CFO) <br /> REGISTRATION/PERMITTING FORMDD <br /> SEP 18 <br /> (CALIFORNIA HOMEMADE FOOD ACT AB 1696 (GATTC4)4jR02020 <br /> PFRMMSET tC E4LrN <br /> CFO Business Name: Owner Name: Date: R E <br /> w �xAaAA <br /> CFO Physical Address: CFO City: CFO Zip: <br /> q�'Ro - i S-�) G52 <br /> Website(If applicable): Telephone: <br /> 20l� <br /> 1. Categories: <br /> 4 "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 end are NOT ALLOWED. Only <br /> foods that are defined as "non-potentially hazardous" are approved for preparatioj� 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 /> "'134R6d woods E] Dried Pasta ElHoney ElPopcorn/Popcorn Balls <br /> ❑ Candy Dry Baking Mixes ❑ Mustard ❑ Vinegar <br /> Churros ❑ Waffle Cones ❑ Dried Grain Mixes ❑ Fruit Butter" <br /> Buttercream Buttercream Ground <br /> Frosting/Icing* ® Fondant/Gu mpaste' Flat Icing ❑ Chocolate <br /> ❑ Dried Male Paste ® Herb/Spice Blends ❑ Pizzeles ❑ Jams/Jellies*" <br /> Nut Mixes/Nut Fried or Baked <br /> ❑ Fruit Empanadas Fruit Tamales/Pies ❑ Butters ❑ Donuts and <br /> Waffles <br /> granola/Cereals ❑ Seasoning Salt ❑ Trail Mix/ Dried Fruit ❑ Dried Fruit <br /> Salted Marshmallows/ <br /> ❑ Cotton Candy [1 Candied Apples Caramel/Fudge ❑ 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 />