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SANJOANN <br />COUNTY— <br />Greatness grows here. <br />CFO Business Name: <br />FreezyFrosty <br />(\e,,,j' C ►2 <br />Environmental Health Department <br />COTTAGE FOOD OPERATIONS (CFO) <br />REGISTRATION/PERMITTING FORM <br />(CALIFORNIA HOMEMADE FOOD ACT AB 1616 (GATTO)) <br />Owner Name: <br />Patricia Vermilus <br />Date: <br />08/13/2022 <br />CFO Physical Address: CFO City: CFO Zip: <br />79 N Menlo Park St. Mountain House 95391 <br />Website (if applicable)yW W.freezyfrosty.Corn Telephone: 209-321-1817 <br />1. Categories: <br />..Class A' (Direct Sales Only) $186 ❑ "Class B" (Direct & Indirect Sales) $312 <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 foods <br />that are defined as "non -potentially hazardous" are approved for preparation by a Cottage Food Operation. These <br />foods include items that do not require refrigeration to keep them safe from bacterial growth that could be a cause of <br />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 <br />Candy ❑ Dry Baking Mixes ❑ Mustard <br />❑ Churros ❑ Waffle Cones ❑ Dried Grain Mixes <br />❑ Buttercream <br />Frosting/Icing* <br />❑ Dried Mole Paste <br />❑ Fruit Empanadas <br />❑ Granola/Cereals <br />❑ Cotton Candy <br />❑ Buttercream ❑ Flat Icing <br />Fondant/Gumpaste* <br />❑ Herb/Spice Blends ❑ Pizzeles <br />❑ Popcorn/ <br />Popcorn Balls <br />❑ Vinegar <br />❑ Fruit Butter** <br />El Chocolate Chocolate <br />❑ Jams/Jellies** <br />El <br />Fruit Tamales/Pies <br />❑ <br />Nut Mixes/Nut <br />Fried or Baked <br />Donuts <br />Butters <br />>6 <br />and <br />Waffles <br />❑ <br />Seasoning Salt <br />❑ <br />Trail Mix/ Dried Fruit <br />Dried Fruit <br />El <br />Candied Apples <br />��( <br />Salted <br />J <br />Marshmallows/ <br />Marshmallow <br />lr <br />Caramel/Fudge <br />�q <br />Bars <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 />