Laserfiche WebLink
(\e0 <br /> (Nee- 2 <br /> Environmental Health Department <br /> SAN J O A Q U I N <br /> ,, 1 . COU NTY— _ <br /> Greotness grows 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 /> '�-)5,A. A,0.A-N bS A-LT NIA-NL- -(1 W 6t- X 6 9 I / 10 /20 <br /> 2 <br /> CFO Physical Address: CFO City: CFO Zip: <br /> 5-3 f'tTTS its 5N )Dry�_ /YLpvA.N-C 4(Al H Uu s r� 9 53 5 <br /> Website(If applicable): Telephone: <br /> /f oK 0 6-1 <br /> 1. Categories: <br /> [E "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 /> Q <br /> Baked Goods ❑ Dried Pasta Hone <br /> ❑ y ® Popcorn/Popcorn Balls <br /> ❑ Candy ❑ Dry Baking Mixes ❑ Mustard ❑ Vinegar <br /> ❑ Churros ❑ Waffle Cones ❑ Dried Grain Mixes ❑ Fruit Butter" <br /> 0 Buttercream © Buttercream ❑ Flat Icing ❑ Ground <br /> Frosting/Icing' Fonda nt/Gum 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 /> 1868 E. Hazelton Avenue Stockton, California 95205 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/ehd <br /> S <br />