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11ex,v) <br />Jas.- . <br />•• :..t , <br />SAN JOAQUIN COUNTY TRO5uk 31-tiq <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: <br />COTTAGE FOOD OPERATIONS (CFO) <br />REGISTRATION/PERMITTING FORM <br />(CALIFORNIA HOMEMADE FOOD ACT AB 1616 (GATTO)) <br />CFO Business Name: A2 Bakeshoppe <br />Owner Name: Abhirami Ravichandran Date: 10/18/2023 <br />CFO Physical Address: 46 E cataldi Avenue CFO City: Mountain house CFO Zip: 95391 <br />VVebsite (If applicable) Telephone . 5102837335 <br />cA‘oh .\ ciNt\N .(o\vi c-11\c/\(\ce (c- (\ (---.)rr\ , <br />1. Cateciones: <br />Er "Class A" (Direct Sales Only) $186 E "Class B" (Direct & Indirect Sales) $486 <br />Prohibited Items: Initial if you agree to abide by the following: A <br />Foods <br />- <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 will be preparing and/or selling. <br />Baked Goods L] Dried Pasta Popcorn/ <br />Popcorn Balls <br />Candy <br />Churros <br />11 Buttercream <br />Frosting/Icing* <br />El Dried Mole Paste <br />0,- Dry Baking Mixes <br />Waffle Cones <br />Buttercream <br />Fondant/Gumpaste" <br />El Herb/Spice Blends <br />Honey <br />Mustard E Vinegar <br />Dried Grain Mixes ▪ Fruit Butter** <br />0 <br />Flat Icing <br />11 Ground 11 Ground <br />Chocolate Chocolate <br />Pizzeles El Jams/Jellies <br />El Fruit Empanadas Fruit Tamales/Pies <br />Granola/Cereals Seasoning Salt <br />El Cotton Candy E Candied Apples <br />EHD 16-27 6/29/2023 1 <br />Fried or Baked <br />E Donuts and <br />Waffles <br />0 Trail Mix/ Dried Fruit Dried Fruit <br />Marshmallows/ <br />El Marshmallow <br />Bars* <br />CFO REG/PERMITTING FORM <br />Nut Mixes/Nut <br />Butters <br />Salted <br />Caramel/Fudge