Laserfiche WebLink
SAN JOAQUIN <br /> <br />Environmental Health Department <br />COTTAGE FOOD OPERATIONS (CFO) <br />REGISTRATION/PERMITTING FORM <br />(CALIFORNIA HOMEMADE FOOD ACT AB 1616 (GATTO)) <br />CFO Business N9me: f <br /> <br />Owner Name: <br />Z-4 —) 6/JAM II I/4/ <br />CFO City: <br />Telephone: <br />7- <br /> <br />Datt7 <br />/77 /2 <br />CFO Zip: <br />7 <br /> <br />CFO Physical Address: <br />A4 /fit <br />VVebsite (If applicable): <br /> <br />C <br /> <br />//a C VA Cet e, <br />Categories: <br /> 1, V1/1 cITA4 <br />Z "Class A' (Direct Sales Only) $186 <br /> <br />111 "Class B" (Direct & Indirect Sales) $312 <br />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 />"Class A" Self Certificallion Checklist: <br />Ell Checklist completed ("Class A" CFOs Only) <br />Products: <br />Please check the items you will be preparing and/or selling. <br />E <br />El <br />El <br />D <br />0 <br />D <br />Baked Goods <br />Candy <br />Churros <br />Buttercream <br />Frosting/Icing* <br />Dried Mole Paste <br />Fruit Empanadas <br />Granola/Cereals <br />Cotton Candy <br />D Dried Pasta <br />Ej Dry Baking Mixes <br />0 Waffle Cones <br />D Buttercream <br />Fondan t/Gumpaste* <br />IE Herb/Spice Blends <br />U Fruit Tamales/Pies <br />El Seasoning Salt <br />Candied Apples <br />ID <br />El <br />0 <br />D <br />0 <br />LI <br />El <br />Honey <br />Mustard <br />Dried Grain Mixes <br />Flat Icing <br />Pizzeles <br />Nut Mixes/Nut <br />Butters <br />Trail Mix/ Dried Fruit <br />Salted <br />Caramel/Fudge <br />Popcorn/ <br />Popcorn Balls <br />D Vinegar <br />0 Fruit Butter** <br />Ground D <br />Chocolate <br />0 Jams/Jellies** <br />Fried or Baked <br />El Donuts and <br />Waffles <br />U Dried Fruit <br />Marshmallows/ <br />Marshmallow <br />Bars* <br />1868 E. Hazelton Avenue I Stockton, California 95205 I 1 209 468-3420 I F 209 464-0138 I www.sjgov.org/ehd