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\2JV2I25, 3:38 PM IMG_9270.jpg 12/ <br />Environmental Health Department <br />*lf a private well, attach all updated water sample results (including quarterly bacteria and Nitrate results.) <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420) F 209 464-0138 | www.sjcehd.com <br />a <br />tps://mail.google.com/mail/u/0/#inbox/FMfcgzQdzmTsfdLKdjqVcwGljGGJcRhQ?projector=1&messagePartld=0.1 1/1 <br />COTTAGE FOOD OPERATIONS (CFO) <br />REGISTRATION/PERMITTING RENEWAL FUF<iv- <br />SAN JOAQUIN <br />------COUNTY------- <br />Greatness grows h.- .• <br />1. Categories: <br />SET ‘Class A' (Direct Sales Only) $186 <br />5. Water Source: <br />Please check what type of water source is being used at the CFO: <br />HZcity Water Private Well* <br />‘Class B" (Direct & Indirect Sales) $486 <br />2- Prohibited Items: Initial if you agree to abide by the following-^) <br />Foods 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-bome illness. <br />3. Products: <br />Provide a list of all products you are preparing. If preparing jams, jellies, or fruit butters include a list of <br />ingredients (attach separate page if needed). <br />Food List <br />6. 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 />4. 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 />It- ir-^2 r <br />CFO Physical Address. CFO City: * <br />Website (If applicable) T^phong- p [ f