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SAN,JOAQUIN <br /> <br />Environmental Health Department <br />CC)11M - <br />COTTAGE FOOD OPERATIONS (CFO) <br />REGISTRATION/PERMITTING RENEWAL FORM <br />CFO Business Name Owner Name <br />Bobbis Buttery Luve Bake! y Bobbi Franco <br />CFO Phys.cal Address CFO Crty. <br />2035 Westboro Ln Manteca <br />Websde 111 applicable) Telephone: <br />(209)597-4967 <br /> <br />Date: <br />9/16/2024 <br />CFO Zip: <br />95336 <br /> <br />Categories: <br />x -Class A (Direct Sales Only) S186 E Class B" (Direct & Indirect Sales) S486 <br />2. Prohibited Items: Initial if you agree to abide by the following: B.;" <br />i-oods containing cream, custard, or meat fillings are potentially hazardous and are NOT ALLOWED Only <br />foods that are defined as -non-potentially hazardous- are approved for preparation by a Cottage Food Operation. <br />These foods include items that do not require refrigeration to keep them safe from bacterial growth that could be a <br />cause of food-borne illness. <br />Products: <br />Provide a list of all products you are preparing. If preparing lams, jellies, or fruit butters include a list of <br />ingredients (attach separate page if needed). <br />Food List: Vanilla cake, Chocolate cake. Snickerdooclie <br />Cake Confetti Cake, Red Velvet Cake, Sugar <br />coolies with Royal icingancl Buttercreom <br />Product Labeling: <br />Attach two labels to this form for two of your CFO products (only one label is required if only one product is <br />made) <br />Water Source: <br />Please check what type of water source is being used at the CEO• <br />NI City Water El Private Well' <br />if a private well, attach all updated water sample results (including quarterly bacteria and Nitrate results ) <br />Food Processor Course: <br />Attach food handler certification for owner and each individual that were not submitted with initial application <br />(including family members and/or employees). <br />1868 E. Hazelton Avenue Stockton, California 95205) T 209 468-3420 1 F 209 464-0138 1 www.sicehd_com <br />FR o9-1-701