Laserfiche WebLink
ne-w- (Neer&. <br />SAN JOAQUIN COUNTY <br /> 1712 osi-1 -12Li <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209)464-0138 Web: www.sioov.oro/EHD <br />COTTAGE FOOD OPERATIONS (CFO) <br />REGISTRATION/PERMITTING FORM <br />(CALIFORNIA HOMEMADE FOOD ACT AB 1616 (GATTO)) <br />CFO Business Narr e <br />S <br />Owner Name Dale: „ <br />WAI/ Azetcl /e;t9/04 3 <br /> <br />CFO Physical Address: <br />02 /76 C/ear Lekka; <br />CFO City: <br />I u-oy <br />CFO Zip: <br />q5—.3 <br /> <br />website (if appitable): Telepriore <br />510-5eg —/-f436 <br />Categories: <br />2/ -Class A (Direct Sales Only) $186 "Class B" (Direct & Indirect Sales) $486 <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. <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 />"Class A" Self Certification Checklist: <br />Checklist completed ("Class A' CFOs Only) <br />Products: <br />Please check the items you wili be preparing andor selling. <br />0 Popcorn/ P Baked Goods 0 Dried Pasta T/H on ey Popcorn Balls <br />Candy 0 Dry Baking Mixes 0 Mustard 0 Vinegar <br />LI Churros r: Waffle Cones EJ Dried Grain Mixes 0 Fruit Butter* <br />0 Buttercream Buttercream CI Flat Icing Ground <br />Frosting/Icing* Fondant/Gumpaste* Chocolate <br />Dried Mole Paste 0 Herb/Spice Blends D Pizzeles [11 Jams/Jellies" <br />Fried or Baked Nut Mixes/Nut LI Fruit Empanadas 0 Fruit Tamales/Pies LI [I] Donuts and Butters Waffles <br />Granola/Cereals LI Seasoning Salt LI Trail Mix/ Dried Fruit (1 Dried Fruit <br />Marshmallows/ <br />El Salted El Cotton Candy F-7, Candied Apples El Marshmallow Caramel/Fudge Bars* <br />FHD 16-27 6/2912023 CFO REGIPERMITI1NG F01110