Laserfiche WebLink
E <br /> Nut Mixes/Nut <br />1-1 Butters <br />Fried or Baked <br />11- Donuts and <br />Waffles <br />Flat Icing LI <br />Pizzeles <br />Ground <br />Chocolate <br />LI Jams/Jellies** <br />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: www siqov orq/EHD <br />COTTAGE FOOD OPERATIONS (CFO) <br />REGISTRATION/PERMITTING FORM <br />(CALIFORNIA HOMEMADE FOOD ACT AB 1616 (GATTO)) <br />— r\ee82: <br />CR <br />CFO Business Name Owner Name: <br />.\71/YDn )--/A Vii\sHcp PRA N iTik <br />CFO Physical Address: CFO City: <br /> <br />Date , <br />cz-)3/i9/2_z_t_ <br />CFO Zip: <br />95377 <br /> <br />2232 DAVIE PI- -TRACY <br />Website (If applicable): Telephone: <br />5103621537 <br />1. Categories: <br />"Class A" (Direct S3les Only) $186 0 "Class B" (Direct & Indirect Sales) $486 <br />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 />"Class A" Self Certification Checklist: <br />IL'Checklist completed ( Class A CFOs Only) <br />Products: <br />Please check the items you will be preparing and/or selling. <br />2. Prohibited Items: <br />Popcorn/ <br />Popcorn Balls M7- Baked Goods E Dried Pasta <br />El Candy E Dry Baking Mixes <br />Churros 0 Waffle Cones <br />Buttercream try Buttercream <br />Frosting/Icing* "c Fondant/Gumpaste* <br />Dried Mole Paste K1' Herb/Spice Blends <br />Fruit Empanadas El Fruit Tamales/Pies <br />Granola/Cereals 0 Seasoning Salt <br />fl Cotton Candy 0 Candied Apples <br />EHD 16-27 6/29/2023 <br />Honey LI <br />mustard E Vinegar <br />Dried Grain Mixes 0 Fruit Butter— <br />0"." Trail Mix! Dried Fruit Kr Dried Fruit <br />Marshmallows/ <br />0 Marshmallow <br />Bars* <br />1 CFO REG/PERMITTING FORM <br />n Salted <br />Caramel/Fudge