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Hand washing is required immediately prior to handling foods and after engaging in <br />any activity that contaminates the hands such as after using the toilet, coughing or <br />sneezing, eating or smoking. <br />Warm water, hand soap and clean towels are available for hand washing. <br />All food ingredients used in the CFO products are from an approved source. <br />Potable water shall be used for hand washing, ware washing and as an ingredient. <br />Is your water source a private well? <br />a. If YES, have you completed testing for bacteria and nitrate? <br />Is your water source a public water system or community services district? <br />Domestic activities such as family meal preparation, dishwashing, clothes washing or <br />ironing, kitchen cleaning or guest entertainment are excluded from the kitchen. <br />Infants, small children, or pets are excluded from the kitchen. <br />Smoking is excluded. <br />Any person with a contagious illness shall refrain from work in the CFO. <br />a. If YES, what is the name of the system or district? <br />Durin • the • e•aration • acka• n • or hand/in. o <br />• s o <br />C1-1-4 iranWthlee- <br />Yes No <br />Food Preparation Requirements (includes packaging and handling): Yes No <br />Labeling Requirements: Yes No <br />A copy of the label has been submitted to this Department for review and approval. <br />I have attached a sample label., <br />By signing below you are certifying that you meet the requirements of the California Homemade Food Act, AB 1616 <br />(Gatto), as it pertains to a "Class A" Cottage Food Operation. Prior to making any changes, I acknowledge that I must <br />notify San Joaquin County Environmental Health Department of any intended changes to the above statement. <br />Cottage Food Operator C ecklist completed and submitted by: <br />&erupt/ ..4-.4 <br />Print Name I Date <br /> <br />FreezeDriedCandyForMe <br />liflies <br />Net Wt. 4oz (113.3g) <br />Made In A Home Kitchen <br />tal)-Q-L <br />todu iC <br /> <br />Manteca CA 95336 <br />Permit# 'Pending* <br />Issued in San Joaquin County <br />Ingredients Made of Sugar. Corn Syrup Hydrogenated palm kemal oil <br />Less than 2% of citric acid. Tapioca dextnn. Modified corn starch <br />Natural and artificial flavors, sodium citrate. Colors (Yellow Slake <br />Red 40 Lake. Yellow 6 Lake. Blue 1 Lake. Yellow 6. Red 40 <br />EHD 16-26 12/27/201: <br /> <br />>CLASS A CHECKLIST <br />Yellow 5 Blue 11 Camauba Wax Gluten Free Gelatin Free