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Mustard El Vinegar <br />Dried Grain Mixes 0 Fruit Butter** <br />Flat Icing El Ground <br />Chocolate <br />El Pizzeles Er Jams/Jellies""* <br />,c,. • sAN sjoijouiN <br />Environmental Health Department <br />COUNTY— <br />Greatness grows here. <br />COTTAGE FOOD OPERATIONS (CFO) <br />REGISTRATION/PERMITTING FORM <br />(CALIFORNIA HOMEMADE FOOD ACT AB 1616 (GATTO)) <br />r, CFO Business Name: <br />-€5 FirljaEle S SWeASO/1 <br />Date: <br />0) 0 ia(X)-:* <br />j I buna EOP <br />ysical Address: <br />, r .jrcte <br />CFO City: CFO Zip. <br />3 1 q63-20 <br />Website ( plicable): Tele(Pione: <br />2- C:k 4::• I 0 <br />Categories: <br /> <br />-Sbc-ta <br />Er "Class A" (Direct Sales Only) $186 "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 />0 Checklist completed ("Class A" CFOs Only) <br />Products: <br />Please check the items you will be preparing and/or selling. <br />Baked Goods Dried Pasta El Honey El Popcorn/ <br />Popcorn Balls <br />E1 Candy <br />Churros <br />Buttercream <br />Frosting/Icing* <br />0 Dried Mole Paste <br />El Fruit Empanadas <br />Granola/Cereals <br />Cotton Candy <br />0 Dry Baking Mixes <br />0 Waffle Cones <br />111 Buttercream <br />Fondant/Gumpaste* <br />D Herb/Spice Blends <br />0 Fruit Tamales/Pies <br />Fried or Baked <br />El Donuts and <br />Waffles <br />Marshmallows/ <br />0 Marshmallow <br />Bars* <br />El Nut Mixes/Nut <br />Butters <br />0 Candied Apples Salted <br />Caramel/Fudge <br />El <br />El Seasoning Salt El Trail Mix/ Dried Fruit El Dried Fruit <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sjgov.org/ehd