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SAN IOAOUIN Environmental Health Department <br />^-2^ 2gMelissaOst* <br />CFOZ<o "75242 <br />‘Class A’ (Direct Sales Only) $186 "Class B" (Direct & Indirect Sales) $486 <br />1868 E Hazelton Avenue | <br />COTTAGE FOOD OPERATIONS (CFO) <br />REGISTRATION/PERMITTING RENEWAL FORM <br />croc” ina, <br />_______"^zs--iz-|-b3bfi <br />1. Categories: <br />5. Water Source: <br />Please check what type of water source is being used at the CFO: <br />City Water P^vate Well* <br />•If a private well, attach all updated water sample results (including quarterly bacteria and Nitrate results ) <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-borne illness. <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 />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 />StocMon California 95205 | T 200 468 3420 | F 209 464 0138 I www sjcehd CC <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 />Foodust t