Laserfiche WebLink
Food Preparation Requirements (includes packaging and handling): Yes No <br />11. Hand washing is required immediately prior to handling foods and after engaging in <br />any activity that contaminates the hands such as after using the toilet, coughing or <br />sneepng, eating or smoking_ <br />12 Warm water, hand soap and clean towels are available for hand washing. <br />13 All food ingredients used in the CFO products are from an approved source. <br />14 Potable water shall be used for hand washing, ware washing and as an Ingredient. <br />15 Is your water source a private well? <br />alt YES, have you completed testing for bacteria and nitrate? <br />16 Is your water source a public water system or community services district/ <br />alt YES, what is the name of the system or district? La-71 i <br />During the preparation, packaging or handfing of CFO products: <br />17. Domestic activities such as family meal preparation, dishwashing, clothes washing or <br />ironing. kitchen cleaning or guest entertainment are excluded from the kitchen. <br />18 Infants, small children, or pets are excluded from the kitchen. <br />19 Smoking is excluded. <br />20 Any person with a contagious illness shall refrain from work in the CFO. <br />Labeling Requirements: Yes No <br />A copy of the Label has been submitted to this Department for review and approval. <br />I have attached a sample label. <br />By signing below yci. are cirtifkng that you meet the requirements of the CaVornz Hcime-7ade Focc Act. AS 1E1,5 <br />.:Gatto:s, as it purloins toi 'Class A' Cottage Food Oz>cration Price lo rreking ay (.:nrIges, I acknawedga that I -rust <br />notity San Joaqu!^ Cou'Ay Env7onmermal -eat h Departrrer.t o4 y intendec changes to the soove statement <br />Cotage Food Operator Ceol-dist completed and submrted by. <br />• <br />rjf <br />11/7/7_•/ <br /> <br />I , _.„, ••• , <br /> <br />Signature Print Name Date <br />C•13 6-'S'122722l 2 CFC CLVS.E.r..