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r.)6. <br />v <br />A <br />,T40100411 • <br />ii!r3uttercream <br />Frosting/Icing* <br />El Dried Mole Paste <br />ZButtercream <br />Fondant/Gumpaste* <br />fl Herb/Spice Blends El Pizzeles <br />0 Ground <br />Chocolate <br />D Jams/Jellies** <br />"12(Flat Icing <br />PRO siViOcif) <br />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: vrjcpiiLUP <br />COTTAGE FOOD OPERATIONS (CFO) <br />REGISTRATION/PERMITTING FORM <br />(CALIFORNIA HOMEMADE FOOD ACT AB 1616 (GATTO)) <br />z 4 <br />CFO Business Name: Confectionately Sweet Owner Name: <br />Zeya Skelton and Alicia amacho <br />Date: 3/18/24 <br />CFO Physical Address: <br />1659 Fairway oaks ct. <br />CFO City: <br />Ripon, CA <br />CFO Zip: <br />95366 <br />Website (If applicable): Telephone: <br />209.701.9418 <br />Categories: <br />."Class A" (Direct Sales Only) $186 D "Class B" (Direct & Indirect Sales) $486 = <br />2. Prohibited Items: Initial if you agree to abide by the following: 4276 <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-rue:wire 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 />D Checklist completed ("Class A" CFOs Only) <br />Products: <br />Please check the items you will be preparing and/or selling. <br />.R#1°13aked Goods <br />0 Candy <br />Churros <br />D <br />D <br />D <br />Dried Pasta <br />Dry Baking Mixes <br />Waffle Cones <br />El <br />U <br />D <br />Honey <br />Mustard <br />Dried Grain Mixes <br />Popcom/ 0 Popcorn Balls <br />El Vinegar <br />D Fruit Butter** <br />1=1 Fruit Empanadas <br />de Granola/Cereals <br />El Cotton Candy <br />Fruit Tamales/Pies <br />D Seasoning Salt <br />0 Candied Apples <br />Nut Mixes/Nut <br />Butters <br /> El Donuts and <br />Waffles <br />Fried or Baked <br />Trail Mix/ Dried Fruit El Dried Fruit <br />Salted <br />Caramel/Fudge <br /> 0 Marshmallow <br />Marshmallows/ <br />Bars* <br />EHD 16-27 6/29/2023 <br />CFO REG/PERMITT1NG FORM