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, SAN JOAQUIN <br /> <br />Environmental Health Department <br />COUN —v <br />COTTAGE FOOD OPERATIONS (CFO) <br />REGISTRATION/PERMITTING FORM <br />(CALIFORNIA HOMEMADE FOOD ACT AB 1616 (GATTO)) <br /> <br />CFO Business Name: Owner Name: Date: <br /> <br />Stars Creation Lathonya Barber <br />06/28/2023 <br />CFO Physical Address: CFO City: CFO Zip: <br />826 Astor Dr. Stockton <br />95210 <br />Website (If applicable): Telephone: <br />www.starscreationlic.com 408-661-0626 <br />Categories: <br />E "Class A" (Direct Sales Only) $186 0 "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 Certification Checklist: <br />ID Checklist completed ("Class A" CFOs Only) <br />Products: <br />Please check the items you will be preparing and/or selling. <br />0 <br />0 <br />El <br />LI <br />0 <br />E1 <br />111 <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 />111 <br />0 <br />0 <br />El <br />El <br />0 <br />0 <br />0 <br />Dried Pasta <br />Dry Baking Mixes <br />Waffle Cones <br />Buttercream <br />Fondant/Gumpaste* <br />Herb/Spice Blends <br />Fruit Tamales/Pies <br />Seasoning Salt <br />Candied Apples <br />11 <br />0 <br />0 <br />0 <br />1=1 <br />El <br />0 <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 />El Popcorn/ <br />Popcorn Balls <br />0 Vinegar <br />0 Fruit Butter** <br />Ground El Chocolate <br />P Jams/Jellies** <br />Fried or Baked <br />1:1 Donuts and <br />Waffles <br />El Dried Fruit <br />Marshmallows/ <br />0 Marshmallow <br />Bars*