Laserfiche WebLink
SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East HazeIton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: wwwsibov.orq/EHD <br /> <br />COTTAGE FOOD OPERATIONS (CFO) <br />REGISTRATION/PERMITTING FORM <br />(CALIFORNIA HOMEMADE FOOD ACT AB 1616 (GATTO)) <br />cF°Z-KKVN -me,tet <br />CFM de <br />Nj,ktip„ 3 ) a(kS abl 7S)2' <br />ZcZkkOrk 2OP7/0 <br />TelePhso vio Website (If applicable): <br />ne <br />ate • ones: <br />"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. <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 />"Cla A" Self Certification Checklist: <br />hecklist completed ("Class A" CFOs Only) <br />Products: <br />Please check the items you will be preparing and/or selling. <br />El <br />111 <br />0 <br />El <br />0 <br />0 <br />1=1 <br />''Herb/Spice <br />Dried Pasta <br />Dry Baking Mixes <br />Waffle Cones <br />Buttercrearn <br />Fondant/Gumpaste* <br />Blends <br />Fruit Tamales/Pies <br />Seasoning Salt <br />Candied Apples <br />0 <br />0 <br />111 <br />El <br />I=1 <br />El <br />CI <br />CI <br />Honey <br />Mustard <br />Dried Grain Mixes <br />Flat Icing <br />Pizzeles <br />Nut Mixes/Nut <br />Butters <br />Trail Mix/ Dried Fruit <br />Salted <br />Caramel/Fudge <br />El Popcorn/ <br />Popcorn Balls <br />El Vinegar <br />C I Fruit Butter** <br />Ei Ground <br />Chocolate <br />CI Jams/Jellies** <br />Fried or Baked <br />0 Donuts and <br />Waffles <br />CI Dried Fruit <br />Marshmallows/ <br />El Marshmallow <br />Bars* <br />111 Baked Goods <br />111 Candy <br />El Churros <br />CI Buttercream <br />Frosting/Icing* <br />CI Dried Mole Paste <br />CI Fruit Empanadas <br />0 Granola/Cereals <br />1=1 Cotton Candy <br />EHD 16-27 6/29/2023 1 CFO REG/PERMITTING FORM