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El Candy <br />E Churros <br />Buttercream <br />Frosting/Icing* <br />111 Dried Mole Paste <br />E1 Fruit Empanadas <br />El Granola/Cereals <br />Cotton Candy <br />LI Dry Baking Mixes <br />El Waffle Cones <br />Buttercream <br />Fondant/Gumpaste* <br />El Herb/Spice Blends <br />El Fruit Tamales/Pies <br />111 Seasoning Salt <br />111 Candied Apples <br />LI <br />pte2k-A010LILI <br />-N25000D3 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: wvvw.siqov.orq/EHD <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 />Saltyy's Cakes Gursimran K Singh <br />9/5/2024 <br />CFO Physical Address: CFO City: CFO Zip: <br />14222 W Byron Rd Tracy 95304 <br />Website (If applicable): Telephone: <br />(209) 321-2113 <br />Categories: <br />E "Class A" (Direct Sales Only) $186 E lass B" (Direct & Indirect Sales) $486 <br />2. Prohibited Items: Initial if you agree to abide by the following: GS <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 />LIII Checklist completed ("Class A" CFOs Only) <br />Products: <br />Please check the items you will be preparing and/or selling. <br />El Baked Goods Popcorn/ <br />Popcorn Balls <br />LI Mustard E Vinegar <br />LI Dried Grain Mixes El Fruit Butter** <br />Ground Flat Icing LI Chocolate <br />Pizzeles El Jams/Jellies — <br />Fried or Baked <br />El Donuts and <br />Waffles <br />Trail Mix/ Dried Fruit LI Dried Fruit <br />Marshmallows/ <br />Marshmallow <br />Bars* <br />111 Dried Pasta 111 Honey <br />n Nut Mixes/Nut <br />Butters <br />n Salted <br />Caramel/Fudge <br />EHD 16-27 6/29/2023 1 CFO REG/PERMITTING FORM