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SAN JOAQUIN COUNTY Pe_ OS\i‘13 <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East HazeIton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.org/EHD <br />COTTAGE FOOD OPERATIONS (CFO) <br />REGISTRATION/PERMITTING FORM <br />(CALIFORNIA HOMEMADE FOOD ACT AB 1616 (GATTO)) <br />CFO Business Name: Sunshine Nutrition Foods LLC <br /> Owner Name: Xijiu (Grace) Li Date 09/06/23 <br />CFO Physical Address: CFO City: CFO Zip: <br />529 Paul Street <br /> Mountain House 95391 <br />Website (If applicable): Telephone: 650-267-3583 <br />Categories: <br />X "Class A" (Direct Sales Only) $186 El "Class B" (Direct & Indirect Sales) $486 <br />Prohibited Items: Initial if you agree to abide by the following: XL <br />Foods containing cream, custard, or meat fillings are potentially hazardous and are NOT ALLOWED. <br />Only foods that are defined as "non-potentially hazardous" are approved for preparation by a Cottage Food <br />Operation. These foods include items that do not require refrigeration to keep them safe from bacterial <br />growth that could be a cause of food-borne illness. <br />lass A" Self Certification Checklist: (\ eeckP_8 <br />X Checklist completed ("Class A" CFOs Only) <br />5. Products: <br />Please check the items you will be preparing and/or selling. <br />X <br />El <br />111 Baked Goods El Dried Pasta <br />0 Candy El Dry Baking Mixes <br />El Churros 0 Waffle Cones <br />El <br />Buttercream <br />Frosting/Icing* El Buttercream <br />Fondant/Gumpaste* <br />El Dried Mole Paste El Herb/Spice Blends <br />El Fruit Empanadas El Fruit Tamales/Pies <br />El Granola/Cereals 0 Seasoning Salt <br />0 Cotton Candy El Candied Apples <br />Honey El Popcorn/ <br />Popcorn Balls <br />Mustard El Vinegar <br />Mixes El Fruit Butter** <br />El Ground <br />Chocolate <br />El Jams/Jellies** <br />Fried or Baked <br />El Donuts and <br />Waffles <br />Trail Mix/ Dried Fruit El Dried Fruit <br />Marshmallows/ <br />El Marshmallow <br />Bars* <br />Dried Grain <br />Flat Icing <br />Pizzeles <br />Nut Mixes/Nut <br />Butters <br />Salted <br />Caramel/Fudge <br />EHD 16-27 6/29/2023 <br /> <br />1 CFO REG/PERMITTING FORM