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s CFO Business Name: □“Class A” (Direct Sales Only) $186 "Class B” (Direct & Indirect Sales) $486 3. 4. Products: Please check the items you will be preparing and/or selling. □ Dried Pasta □□HoneyBaked Goods □□ Vinegar□ Dry Baking MixesCandy Mustard □ Waffle Cones □Dried Grain MixesChurros □□Flat Icing □PizzelesDried Mole Paste □□□ Fruit Tamales/PiesFruit Empanadas □ Dried Fruit□□ Seasoning Salt □Trail Mix/ Dried FruitGranola/Cereals □ Candied Apples□Cotton Candy 1 CFO REG/PERMITTING FORMEHD 16-27 6/29/2023 Popcorn/ Popcorn Balls Buttercream Frosting/lcing* COTTAGE FOOD OPERATIONS (CFO) REGISTRATION/PERMITTING FORM (CALIFORNIA HOMEMADE FOOD ACT AB 1616 (GATTO)) Buttercream Fondant/Gumpaste* Salted Caramel/Fudge Nut Mixes/Nut Butters Ground Chocolate San Joaquin County Environmental Health Department 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.siqov.org/EHD □ □ “Class A” Self Certification Checklist: M Checklist completed (“Class A” CFOs Only) Marshmallows/ □ Marshmallow Bars* Fried or Baked □ Donuts and Waffles CFO Business Name: ‘ mply stPbgT CFO Physical Address: CFO City: 2£>2>| 3u.. Website (If applicable): 1 1. Categories: 2. Prohibited Items: □ Herb/Spice Blends OTlephone: Initial if you agree to abide by the following: > Foods containing cream, custard, or meat fillings are potentially hazardous and are NOT ALLOWED. Only foods that are defined as “non-potentially hazardous” are approved for preparation by a Cottage Food Operation. These foods include items that do not require refrigeration to keep them safe from bacterial growth that could be a cause of food-borne illness. □ Fruit Butter** □ Jams/Jellies**