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S' <br />9/22/2025Lauren Gutierrez Date:Owner Name:CFO Business Name: <br />CFO Zip:95320CFO City:CFO Physical Address:Escalon, ca2409 California st <br />(209)923-0932 <br />□“Class B" (Direct & Indirect Sales) $486“Class A” (Direct Sales Only) $186 <br />LG <br />2. Prohibited Items: <br />4. Products: <br />Please check the items you will be preparing and/or selling. <br />□□Baked Goods HoneyDried Pasta <br />□ Vinegar□□□MustardDry Baking MixesCandy <br />□ Fruit Butter**□□□Dried Grain MixesWaffle ConesChurros <br />□□□□Flat Icing <br />□□□PizzelesHerb/Spice BlendsDried Mole Paste <br />□□□Fruit Tamales/PiesFruit Empanadas <br />□ Dried Fruit□□□Trail Mix/ Dried FruitSeasoning SaltGranola/Cereals <br />□□□Candied ApplesCotton Candy <br />CFO REG/PERMITTING FORM1EHD 16-27 6/29/2023 <br />COTTAGE FOOD OPERATIONS (CFO) <br />REGISTRATION/PERMITTING FORM <br />(CALIFORNIA HOMEMADE FOOD ACT AB 1616 (GATTO)) <br />Oak + Ember <br />Sourdough <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 />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.siqov.org/EHD <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 />Marshmallows/ <br />□ Marshmallow <br />Bars* <br />Fried or Baked <br />□ Donuts and <br />Waffles <br />1. Categories: <br />^0 <br />Buttercream <br />Frosting/lcing* <br />3. “Class A” Self Certification Checklist: <br />S0Checklist completed (“Class A” CFOs Only) <br />^W^'/Wtagram.com/oak.and.eW^ourdough <br />□ Jams/Jellies**