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Example: <br />BIG CAKE BAKER <br />Stockton CA 95209 <br />Perm it# 012345 <br />Issued in: San Joaquin County <br />Chocolate Chip Cookies with Walnuts <br />Ingredients En ri&ed flotr (wheat flour, niacin, reduced iron, thiarnile, moncoitrate, riboflavin <br />and folic acid), Incur (rrilk, salt), chocobtoclips (sugar, chocolate liquor, cocoa butter, butterfat <br />(milk), walnuts, stgar, eggs, salt, artificial vanilla extract, baking sock <br />Contains: Wheat, milk, eggs, soy, walnuts <br />Made in a home kitchen <br />Net Wt. 3 oz. (85.05g) <br />Note: For the "Issued in County"- Identify the jurisdiction (city/county) where you are obtaining approval. <br />My Label: <br />Sunshine Nutrition Foods LLC <br />Mountain House , CA 95391 <br />Permit# <br />Issued in: San Joaquin County <br />Wild Flavor Peanuts <br />Ingredients: Peanuts, sugar, vegetable oil, corn starch , chili powder, salt, pepper <br />Contains: Peanut, Corn Starch <br />Made in a home kitchen <br />Net Wt. 8 oz. (226.80g) <br />7. Disposal of Waste: <br />Please check what type of treatment is used to dispose of waste <br />X Public Sewer Service 111 Private Septic System <br />In the event of septic system failure or plumbing problem, you are required to notify San Joaquin County Environmental Health <br />Department immediately. <br />END 16-27 6/29/2023 <br /> 5 CFO REG/PERMITTING FORM