Laserfiche WebLink
5 au hi42-1 13/W--C-- 5 ft0 12 <br />CFO Physical Address- <br />SO7 KIN 6) Eizq W <br />KP-tsnor <br />CFO City: <br />R PO <br />Date: <br />12" 2 -211- <br />CFO Zip: <br />615 1t9 0 <br />CFO Business Name: Owner Name: <br />1:1 Baked Goods <br />I:g Candy <br />Churros <br />Ei Buttercream <br />Frosting/Icing* <br />E Dried Mole Paste <br />Fruit Empanadas <br />VA Granola/Cereals <br />Cotton Candy <br />PR us-7/ q3. SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: vvww.sigov.orq/EHD <br />COTTAGE FOOD OPERATIONS (CFO) <br />REGISTRATION/PERMITTING FORM <br />(CALIFORNIA HOMEMADE FOOD ACT AB 1616 (GATTO)) <br />Website (If applicable): Telephone: <br />Sal) lkiLES 3 PC14- HI) P.0 frl 2-067 -12(pi-Gsoc1 <br /> <br />Categories: <br />E -Class A" (Direct Sales Only) $186 "Class B" (Direct & Indirect Sales) $486 <br />Prohibited Items: Initial if you agree to abide by the following: KY <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 /> RECEIVED <br />0 Checklist completed ('Class A" CFOs Only) <br />DEC 06 2024 <br />Products: <br />ENVIRONNIENTAL <br />Please check the items you will be preparing and/or selling. <br /> DEM RTNIENT <br />END 16-27 6/29/2023 <br />E <br />E <br />CI <br />0 <br />E <br />D <br />Li <br />Dried Pasta <br />Dry Baking Mixes <br />Waffle Cones <br />Buttercream <br />Fondant/Gumpaste* <br />Herb/Spice Blends <br />Fruit Tamales/Pies <br />Seasoning Salt <br />Candied Apples <br />E <br />D <br />E <br />E <br />ni <br />"—I <br />E <br />Ler <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 />0 Popcorn/ <br />Popcorn Balls <br />El Vinegar <br />0 Fruit Butter** <br />CI Ground <br />Chocolate <br />El Jams/Jellies** <br />Fried or Baked <br />E Donuts and <br />Waffles <br />CI Dried Fruit <br />Marshmallows/ <br />E Marshmallow <br />Bars* <br />1 CFO REG/PERMITTING FORM