Laserfiche WebLink
r <br />“Class A" (Direct Sales Only) $186 “Class B” (Direct & Indirect Sales) $486 <br />2. Prohibited Items: <br />4. Products: <br />Please check the items you will be preparing and/or selling. <br />□□ Dried Pasta □□Baked Goods Honey <br />□□ Dry Baking Mixes □□ VinegarCandyMustard <br />□□ Waffle Cones □□ Fruit Butter**Churros Dried Grain Mixes <br />□□□□Flat Icing <br />□□ Herb/Spice Blends □□ Jams/Jellies**Dried Mole Paste Pizzeles <br />□□ Fruit Tamales/PiesFruit Empanadas <br />□□ Seasoning Salt □□ Dried FruitGranola/Cereals Trail Mix/ Dried Fruit <br />□□ Candied Apples □Cotton Candy <br />EHD 16-27 6/29/2023 1 CFO REG/PERMITTING FORM <br />Buttercream <br />Frosting/lcing* <br />COTTAGE FOOD OPERATIONS (CFO) <br />REGISTRATION/PERMITTING FORM <br />(CALIFORNIA HOMEMADE FOOD ACT AB 1616 (GATTO)) <br />San Joaquin County <br />Environmental Health Department <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjqov.org/EHD <br />Buttercream <br />Fondant/Gumpaste* <br />Salted <br />Caramel/Fudge <br />Nut Mixes/Nut <br />Butters <br />Ground <br />Chocolate <br />Popcorn/ <br />Popcorn Balls <br />Date: <br />CFO Zip: <br />C /? Trxxo <br />Marshmallows/ <br />□ Marshmallow <br />Bars* <br />Fried or Baked <br />□ Donuts and <br />Waffles <br />1. Categories: <br />□ <br />3. “Class A” Self Certification Checklist: <br />□ Checklist completed ("Class A” CFOs Only) <br />Initial if you agree to abide by the following: <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 />___ Owner Name: <br />C 6*^ C <br />CTO City: <br />Telephone: <br />________________753/ <br />CFO Business Name: <br />CFO Physical Address: <br />Website (If applicable):