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Food Preparation Requirements (includes packaging and handling): Yes No Hand washing is required immediately prior to handling foods and after engaging in any activity that contaminates the hands such as after using the toilet, coughing or E CI sneezing, eating or smoking. Warm water, hand soap and clean towels are available for hand washing. E El All food ingredients used in the CFO products are from an approved source. Eli Potable water shall be used for hand washing, ware washing and as an ingredient. El E Is your water source a private well? El E a. If YES, have you completed testing for bacteria and nitrate? Lii El Is your water source a public water system or community services district? E El a. If YES, what is the name of the system or district? Reclamation district no 2074 Yes No During the preparation, packaging or handling of CFO products: Domestic activities such as family meal preparation, dishwashing, clothes washing or E CI ironing, kitchen cleaning or guest entertainment are excluded from the kitchen. Infants, small children, or pets are excluded from the kitchen. E 111 Smoking is excluded. E CI Any person with a contagious illness shall refrain from work in the CFO. E CI Labeling Requirements: Yes No A copy of the label has been submitted to this Department for review and approval. I have attached a sample label. By signing below you are certifying that you meet the requirements of the California Homemade Food Act, AB 1616 (Gatto), as it pertains to a "Class A" Cottage Food Operation. Prior to making any changes, I acknowledge that I must notify San Joaquin County Environmental Health Department of any intended changes to the above statement. Cottage Food Operator Checklist completed and submitted by: • Tobias Handschin 8/19/2024 Sicfnature Print Name Date EHD 16-26 12/27/2012 2 CFO CLASS A CHECKLIST