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BIG CAKE BAKER <br />Stockton CA 95209 <br />Perm R14-012345 <br />Issued in: San Joaquin County <br />Chocolate Chip Cookies with Walnuts <br />I rued lents: Enriched flour (wheat flour, niacin, reduced iron, thiamine, mononitrate, riboflavin <br />and folic acid), butter (milk, salt), ch-ocolate c hips (argar, chocolate liquor, cocoa butte-, butterfat <br />(milk), walnuts, sugar, eggs, salt, artificial vanilla extract, barg soda <br />Contains: Wheat, milk, eggs, soy, walnuts <br />Made in a home kitchen <br />Net Wt. 3 oz. (85.05g) <br />Example: <br />came Lt. Lo, <br />Egk h7/3 /7 <br />PUV <br />ve <br />2-0 2?-75--co <br />(hv 1-4(.014e. Y <br />'Aid- but oz, 1.5 1-13 <br />Note: For the issued in County" - Identify the jurisdiction (city/county) where you are obtaining approval. <br />6. Disposal of Waste: <br />Please check what type of treatment is used to dispose of waste <br />El Public Sewer Service CI 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 />7. Water Source: <br />Pease identify the water source to be used in Cottage Food Facility (check one box) <br />CI Name of Public Water System or Community Services District: <br />I=1 Private Water Supply**, Identify the source (well, spring, surface, etc.): <br /> <br />Private Water Supply: Initial Water Quality Results <br /> <br />Check boxes below if initial water testing has been completed. <br />All testing must be done at a State Certified Laboratory. Either attach lab results or provide name of lab, date & <br />results in space provided next to type of test. <br />k(Testing frequency for transient Non-Community Water Systems after initial testing) <br />El Bacteriological Test (quarterly*): <br />CI Nitrate Test (yearly*): <br />EHD 16-27 6/29/2023 4 CFO REG/PERMITTING FORM <br />.11 Jo yr