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Example: <br />Chocolate Chip Cookies with Walnuts <br />Contains: Wheat, milk, eggs, soy, walnuts <br />For the Issued in Couit^ - identify the jurisdiction (dfy/county) where you are obtaining apprwaL <br />CFO REGramrmMG FORM00^27 wawaezj 4 <br />r <br />Made in a home kitchen <br />Net Wt 3 oz. (85.05g) <br />BIG CAKE BAKER <br />Stockton CA 95209 <br />Permit# 012345 <br />Issued in: San Joaquin County <br />6. Disposal of Waste: <br />Please check what type of treatment is used to dispose of waste <br />O^ubfc Sewer Service Private Septic System <br />In the evert of septic system Mure or pksnbinQ problem, you are required to notify San Joaquin County Envworanantal Heaith <br />Dapartarent amNdMely. <br />7. Water Source: <br />Pease Identify the water source to be used in Cottage Food Facmty (check one box) <br />Q^iame of PubOc Water System or Community Services District <br /> Private Water Supply**. Identify the source (weB, spring, surface, eto.):^ <br />Private Mrtar Supply. MM Writer Qu^lty Reeulta <br />Check boxes betowtfinffiai water testing has been competed. <br />Al testtog must be done at a State Certified Laboratory. Efflw attach lab results or provide name of tab, date & <br />resists in space provided next to type of test <br />‘(Tesfing frequency for transient Non-Community Water Systems alter Wtei testing) <br /> Bacteriological Test (quarterly*): <br /> Nitrate Test (yearly^: ——————— — <br />Irxrednrxs: Enrrhed fkxr (wheat flour, niaon, rnlixad iron, themine, monantxwa, nixifla^n <br />»%dfdc acri), buner (rrik, sah}, drocotarechifa (supr, dxxciMeliqux, cocMbiXter, hnrerfM <br />waifXJts, s<», egxs, saix. arbfidal vanita extratt, tekirt x>da