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S A N J O A Q U I N Environmental Health Department <br /> --COUNTY----- <br /> Greatness gro:vs 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 /> CFO Physical Address: CFO City: CFO Zip: <br /> Websfte(If applicable): Telephone: <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 ❑ Dried Pasta El Honey El Popcorn <br /> Popcorn Balls <br /> ❑ Candy ❑ Dry Baking Mixes ❑ Mustard ❑ vinegar <br /> ❑ Churros ❑ Waffle Cones ❑ Dried Grain Mixes [I Fruit Butter` <br /> ❑ Buttercream ❑ Buttercream E] Flat Icing ❑ Ground <br /> Frosting/Icing' Fondant/Gumpaste` Chocolate <br /> ❑ Dried Mole Paste ❑ Herb/Spice Blends ❑ Pizzeles ❑ Jams/Jellies" <br /> Nut Mixes/Nut Fried or Baked <br /> E] Donuts and <br /> ElFruit Empanadas ElFruit Tamales/Pies 1:1Butters <br /> Waffles <br /> ❑ Granola/Cereals ❑ Seasoning Salt ❑ Trail Mix/Dried Fruit ❑ Dried Fruit <br /> Salted Marshmallows/ <br /> El Cotton Candy El Candied Apples ElCaramel/Fudge El Marshmallow <br /> Bars <br /> ❑ VeDrigetables Dehydrated El rid <br /> Soup Mixes L] Vegetable and Potato Chips <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209468-34201 F 209464-0138 1 www.sjgov.org/EHD <br />