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^0LI C <br /> “Class B" (Direct & Indirect Sales) $486 <br />4. Products: <br />Please check the items you will be preparing and/or selling. <br />ja Dried Pasta HoneyBaked Goods <br /> Dry Baking Mixes Mustard VinegarCandy <br /> Dried Grain Mixes Fruit Butter** Waffle ConesChurros <br /> Flat Icing <br /> Pizzeles Jams/Jellies** Herb/Spice BlendsDried Mole Paste <br /> Fruit Tamales/PiesFruit Empanadas <br /> Trail Mix/ Dried Fruit Dried Fruit Seasoning SaltGranola/Cereals <br /> Candied ApplesCotton Candy <br />CFO REG/PERMUTING FORM1EHD 16-27 6/29/2023 <br />Buttercream <br />Frosting/lcing* <br />Buttercream <br />Fondant/Gumpaste* <br />Nut Mixes/Nut <br />Butters <br />Salted <br />Caramel/Fudge <br />Popcorn/ <br />Popcorn Balls <br />Ground <br />Chocolate <br />1. Categories: <br />“Class A" (Direct Sales Only) $186 <br />Date: <br />A/17/26 <br />CFO Zip: <br />95337 <br />Owner Name: <br />^.ole <br />CFO city: <br />VAnn-terrx <br />Telephone: <br />Fried or Baked <br /> Donuts and <br />Waffles <br />Marshmallows/ <br /> Marshmallow <br />Bars* <br />CFO Business Name: <br />Midnight HdCn rpf) <br />CFO Physical Address <br />929 GoA-fon <br />Website (If applicable): <br />fl/a <br />2- Prohibited Items: Initial if you agree to abide by the following: G <br />Foods containing cream, custard, or meat fillings are potentially hazardous and are NOT ALLOWED. <br />Only foods that are defined as “non-potentially hazardous” are approved for preparation by a Cottage Food <br />Operation. These foods include items that do not require refrigeration to keep them safe from bacterial <br />growth that could be a cause of food-borne illness. <br />3. “Class A” Self Certification Checklist: <br />Checklist completed (“Class A" CFOs Only) <br />COTTAGE FOOD OPERATIONS (CFO) <br />REGISTRATION/PERMITTING FORM <br />(CALIFORNIA HOMEMADE FOOD ACT AB 1616 (GATTO)) <br />$ <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.siqQv.org/EHD <br />^^^5 - ■