Laserfiche WebLink
S1, sy ( Y <br /> SAN JOAQUIN Environmental Health Department <br /> COTTAGE FOOD OPERATIONS (CFO) <br /> REGiSTRATIONIPERMITTING RENEWAL FORM <br /> CFO Bw'nosa Na°�'�pQe aavw Ne <br /> te: <br /> �tg C�hf1l'tC)rkr�� <br /> CFO Rxsical Adlvv s: CFO Gly: cro zip: <br /> i.)U + Llo4d '�}) L:trr Lode <br /> website(It appli=0e <br /> 1. Categories: <br /> ❑ 'Class A'(OnecL Sales Orgy)$155 1�e 'Class S' (Direct&Indirer-t sales)sato <br /> 2. Prohibited Items: Initial If you agree to abide by the following: Lil <br /> Foods containing cream, custard, or meat Illlings 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. Products: <br /> Provide a list of all products you are preparing. If preparing jams,jellies,or fruit hutters include a list of <br /> ingredients (attach separate page if needed). <br /> Food Lrsl: t <br /> 4. Product Labeling: <br /> Attach two labels to this foam for two of your CFO products(onlyone label is required if only one product is <br /> made). <br /> 5. Water Source: <br /> Please chsck whof type of water source is being used of the CFO: <br /> City Water ❑ Private Weir <br /> 'if a private well,attach all updated water sample results(ftiLtdin0 quarterly bacteria and Nitrate results.) <br /> 6. Food Processor Course: <br /> Attach food handler certification tar owner and each Individual that were not submitted with Initial application <br /> including farniy members and/or employees). <br /> 1 Wig E. Hn7ehrni Avenue J Stockton,Californla 9521551 T 27.1469-:4120 I F 208 464-1138 I wwv aJcehd com <br /> s <br />