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i <br /> Example: <br /> BIG CAKE BAKER <br /> Stockton CA 95209 <br /> Pe rm it#0223 45 <br /> issued in: San Joaquin County <br /> i <br /> Chocolate Chip Cookies with Walnuts <br /> Ingredients:Enriched flcur(wheat flour,niacin,reduced iron,thiamine,mcnccitrate,riboflavin <br /> and folic acid),butter(milk,salt),chocolatechips(sugar,chocclate liquor, cocoa butter,butterfat <br /> (milk),walnuts,sugar,eggs,salt,artificial vanilla e)tract,baking soda <br /> Contains: Wheat, milk, eggs, soy, walnuts <br /> Made in a home kitchen <br /> I <br /> Net Wt. 3 oz. (85.05g) <br /> Note:For the"Issued in County"-Identify the jurisdiction(city/county)where you are obtaining approval. <br /> 6. Disposal of Waste: <br /> Please check what type of treatment is used to dispose of waste <br /> FtIPublic Sewer Service ,5rivate 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 /> K�/Name of Public Water System or Community Services District: <br /> rlPrivate Water Supply", Identify the source (well, spring, surface, etc.): l <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 /> EHD 16-27 6/29/2023 4 CFO REG/PERMITTING FORM <br />