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SAN�j10AQUIN <br /> Environmental HT tnt <br /> " y COUNTY u ' ��r �.. <br /> `0Greatness grows herd <br /> FEB 10 2021 <br /> COTTAGE FOOD OPERATIONS (CFO) <br /> REGISTRATION/PERMITTING FORM ENV���nNPAENTgL HEALTH <br /> (CALIFORNIA HOMEMADE FOOD ACT AB 1616 (GATTO)) <br /> CFO Business Name: Owner Name: Date: <br /> Julie's Home Sweet & Savory Treats Julie Manivong 02/10/2021 <br /> CFO Physical Address: CFO City: CFO Zip: <br /> 144 E Walnut St Stockton 95204 <br /> Website(if applicable): Telephone: <br /> (209) 496-8019 ;t,��t�S�IU�YI�.� �,�� 4S���v�fy �►�t�c fs <br /> cy" hoc, - Cc, YYII <br /> 1. Categories: J <br /> K1 "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 ❑ Dried 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 [N Flat Icing El Ground <br /> Frosting/Icing* Fonda nt/Gu m paste* Chocolate <br /> ❑ Dried Mole 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 ❑ 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 />