Laserfiche WebLink
r'0 SAN -f OAN I N Environmental Health Department <br /> —COUNTY— <br /> "'< r Greatness grows he: <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 /> Suamalie Ano Mariah Taloa 3/8/2021 <br /> CFO Physical Address: CFO City: CFO Zip: <br /> 1571 Peony Drive Tracy, CA 95377 <br /> Website(If applicable): Telephone: <br /> In Process 209-237- 6543 <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 /> Baked Goods El Dried Pasta El Honey El Popcorn <br /> Popcorn Balls <br /> V Candy VDry Baking Mixes ❑ Mustard ❑ Vinegar <br /> ❑ Churros ❑ Waffle Cones ❑ Dried Grain Mixes ❑ Fruit Butter** <br /> Buttercream VButtercream Flat IcinGround <br /> Frosting/Icing* Fondant/Gumpaste* g El <br /> ❑ Dried Mole Paste ❑ Herb/Spice Blends ❑ PizzelesJams/Jellies** <br /> �/ Nut Mixes/Nut reed or Baked <br /> M Fruit Empanadas Fruit Tamales/Pies ❑ Butters NF Donuts and <br /> Waffles <br /> ❑ Granola/Cereals ❑ Seasoning Salt ❑ Trail Mix/Dried Fruit ❑ Dried Fruit <br /> Salted Marshmallows/ <br /> ❑ Cotton Candy ❑ 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 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/EHD <br />