Laserfiche WebLink
SAN._J0AQUIN Environmental Health Department <br /> COUNTY <br /> Greotness gro:,s here. <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 /> �)7 SU&�AL Al\j OS A-LT K I A-N(;, z 1 W Gr a� I / I u /2c a` l <br /> CFO Physical Address: CFO City: CFO Zip: <br /> 5-3 A_/i�__ Nkyufq-C 4f lv 1-I Uus i— c, j <br /> Website(If applicable): Telephone: <br /> 1. Categories: <br /> M "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: T� <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 /> Q 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 INButtercream El Flat Icing ❑ Ground <br /> Frosting/Icing* Fonda nt/Gumpaste* Chocolate <br /> ❑ Dried Mole Paste ❑ Herb/Spice Blends ❑ Pizzeles ❑ Jams/Jellies** <br /> Nut Mixes/Nut Fried or Baked <br /> F] Fruit Empanadas El Fruit Tamales/Pies Elgutters W1 Donuts and <br /> Waffles <br /> ❑ Granola/Cereals ❑ Seasoning Salt ❑ Trail Mix/Dried Fruit ❑ Dried Fruit <br /> SaltedMarshmallows/ <br /> ❑ Cotton Candy ElCandied Apples Caramel/Fudge El Marshmallow <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 />