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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.sibov.org/EHD <br />_— <br />Pe <br />COTTAGE FOOD OPERATIONS (CFO) <br />REGISTRATION/PERMITTING FORM <br />(CALIFORNIA HOMEMADE FOOD ACT AB 1616 (GATTO)) <br />CFO Business Name: Owner Name: Date: <br />Browned Butter Bakery <br /> Erica Jabouri <br /> <br />8/3/2024 <br />CFO Physical Address: CFO City: CFO Zip: <br />408 Rina Dr <br />Manteca CA <br /> 95337 <br />Website (If applicable): <br /> <br />Telephone: <br />209-482-4399 <br />Categories: <br /> <br />111 "Class A" (Direct Sales Only) $186 X "Class B" (Direct & Indirect Sales) $486 <br />Prohibited Items: Initial if you agree to abide by the following: <br /> <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 />El Checklist completed ("Class A" CFOs Only) <br />Products: <br />Please check the items you will be preparing and/or selling. <br />X Baked Goods <br />LIII Candy <br />El Churros <br />X Buttercream <br />Frosting/Icing* <br />[II Dried Mole Paste <br />LI Fruit Empanadas <br />El Granola/Cereals <br />111 Cotton Candy <br />E Dried Pasta CI Honey <br />El Dry Baking Mixes CI Mustard <br />CI Waffle Cones CI <br />Buttercream <br />Fondant/Gumpaste* <br />El Herb/Spice Blends CI <br />El Fruit Tamales/Pies CI <br />El Seasoning Salt CI <br />El Candied Apples <br />El Popcorn/ <br />Popcorn Balls <br />El Vinegar <br />El Fruit Butter** <br />Ground El Chocolate <br />El Jams/Jellies** <br />Fried or Baked <br />E Donuts and <br />Waffles <br />El Dried Fruit <br />Marshmallows/ <br />Marshmallow <br />Bars" <br />Dried Grain Mixes <br />Flat Icing <br />Pizzeles <br />Nut Mixes/Nut <br />Butters <br />Trail Mix/ Dried Fruit <br />Salted <br />Caramel/Fudge <br />EHD 16-27 6/29/2023 1 <br /> <br />CFO REG/PERMITTING FORM