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Exa►nhle: <br /> BIG CAKE BAKE fi <br /> Stockton CA 95209 <br /> Pe rm itK 011345 <br /> oairrf in San Joaquin Coll- . <br /> Chocolate Chip Cookies with Walnuts <br /> 1%redients Enrict%ed f lour Iwheatflour.rdacin,reduced iron,thiamine,manwitrm,� fibov"3,ir <br /> andfalic acid).butter(rr"K,salt).chocolatechips(sugar,chocdate liquor,ccwa l:tr'n,,.,yrs-fat i <br /> (mi1t1,walnuts sugar,eggs,salt artficialvanilla extract,bating-eda f� <br /> Contains: Wheat. milk, eggs, soy, walnuts ' <br /> i <br /> Made In a home kitchen' <br /> Net Wt. 3 oz. (85.058) <br /> I <br /> I <br /> Note For the'Issued in County"-Identify the jurisdiction(city/county)where you are obtaining apprcvai <br /> 6. Disposal of Waste: <br /> Please check what type of treatment is used to dispose of waste <br /> lIZ ' Jblic Sewer Service ❑ 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 /> O-Name of Public Water System or Community Services District: 1 <br /> 1 `104►N'T-�1 til V r 3� SEL <br /> ❑ Private Water Supply", Identify the source (well, spring, surface, etc.): <br /> Private Water Supply:Initial Water Quality Results <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 /> '(Testing frequency for transient Non-Community Water Systems after initial testing) <br /> ❑ Bacteriological Test(quarterly'): <br /> ❑ Nitrate Test(yearly'): <br /> L <br /> / 2023 4 CFO REG/PERMITTING FORM <br />