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SAN 10AQ U I N Environmental Health Department <br /> test _ COUNTY <br /> .. <br /> Greotness grows here. <br /> COTTAGE FOOD OPERATIONS (CFO) <br /> REGISTRATION/PERMITTING FORM <br /> (CALIFORNIA HOMEMADE FOOD ACT AB 1616 (GATTO)) <br /> CFO Business Name: Owner Name: Date: <br /> Sweet Temptations Bakeshop Kristie Ormonde <br /> CFO Physical Address: CFO City: CFO Zip: <br /> 550Sandy Ln.#812 Ripon, CA 95366 <br /> Website(If applicable): Telephone: <br /> (209)968-5800 <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: KLO <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 /> V Checklist completed("Class A"CFOs Only) <br /> 4. Products: <br /> Please check the items you will be preparing and/or selling. <br /> ® Baked Goods ElDried Pasta ❑ Honey ® Popcorn/ <br /> Popcorn Balls <br /> ® Candy ❑ Dry Baking Mixes ❑ Mustard ❑ Vinegar <br /> ❑ Churros ❑ Waffle Cones ❑ Dried Grain Mixes ❑ Fruit Butter" <br /> Buttercream Buttercream Ground <br /> ® FrostingAcing' ® Fondant/Gumpaste' ® Flat Icing ❑ Chocolate <br /> ❑ Dried Mole Paste ❑ Herb/Spice Blends ❑ Pizzeles ❑ Jams/Jellies'" <br /> Nut Mixes/Nut Fried or Baked <br /> ❑ <br /> Fruit Empanadas ❑ Fruit Tamales/Pies ElBuffers ❑ Donuts and <br /> Waffles <br /> ❑ Granola/Cereals ❑ Seasoning Salt ❑ Trail Mix/Dried Fruit ❑ Dried Fruit <br /> Salted Marshmallows/ <br /> ❑ Cotton Candy ElCandied Apples Caramel/Fudge ® Marshmallow <br /> Bars' <br /> Dried or Dehydrated Dried Vegetarian <br /> ElDried <br /> ❑ Based Soup Mixes ❑ Vegetable and Potato Chips <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />