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Example: <br />Chocolate Chip Cookies with Walnuts <br />Contains: Wheat rnilk. eggs, soy, walnuts <br />iVgte' For ‘.De 'Issued in Cawrny* - Jcfanfiiy lunsdcbon (ctytairityj Mtere you are oMai'rV.’ip dppvvBi <br />6. Disposal of Waste: <br />7. Waler Source: <br />tvai <br /> <br />4EHD 16-.?7 CPC HEG-PLftMIHlNG f'C^r.1' <br />Made in a home kitchen <br />Net V^. 3 oz. (85,05g) <br />Ircreff'B'IX ErrCMK! ffcv|wn«acflaur, nicr, rcd-ccdirsr.^sr-ire, r-a-anrtrz-t rbcfUsi- <br />•rdW* xd), scswf ««•;, tf-OCCWesrips Isupr, a- oc^rc-quc-'. c=<=«tcnar, bj“Br’=t <br />InaKi, v<*h%*k Kfr. -i»j m4\ MfiuiScin* ecrac taHrjzzsi <br />Pease Identify the water source to be used in Cottaga food facility (check one box) <br />□ Name ot Public Water System or Community Services District: <br />Private Water Supply**. Identify the source (well, spring, surface, etc.): <br />Private Water Supply, initial Water Quality Results <br />Cheek boxes belay# if inibal water testing has been campltted <br />All testing must be done at a State Cart nod Laboratory Either attach lab nssJts or provide mme of lab. date & <br />results m space provided next To type o?*e$1 <br />•(Testng frequency far transient N-on-Communrty Water Systems after in4iol testing) <br />□ BaeteriDlcgsaal Test (quarterly*): <br />□ Nitrate Test (yearly*): <br />BIG CAKE BAKER <br />Stockton CA 95209 <br />Perm 011545 <br />sued n. San Joaquin County <br />Please check what type of treatment is used to dispose of waste <br />□ Public Sewer service Private Septic System <br />in the everc ot septle r/Hteni failure or plumbing prebtem, yai are required :o notify San Joaquin County EnvitcnmemUI Hearth <br />Department Irniriediately