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Environmental Health Department <br />■’jjPOV1' <br />CFO City:CFO Zip: <br />Email address, laura.padilla0127@gmail.com <br />1. Categories: <br />□0 “Class B” (Direct & Indirect Sales) $486"Class A" (Direct Sales Only) $186 <br />2. Prohibited Items: <br />3. Products: <br />Food List: <br />Baked goods, candy, chocolate, waffle cones, flat icing, fruit empanadas, churros, buttercream frosting, coffee. <br />5. Water Source: <br />If a private well, attach all updated water sample results (including quarterly bacteria and Nitrate results.) <br />6. Food Processor Course: <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjcehd.com <br />Website (If applicable): <br />shuga-momma-cakes.square.site <br />CFO Physical Address: <br />26735 Airport Ct Manteca, CA 95337 <br />CFO Business Name: <br />Shuga Momma Cakes and Cupcakes <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 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 />Attach food handler certification for owner and each individual that were not submitted with initial application <br />(including family members and/or employees). <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 />COTTAGE FOOD OPERATIONS (CFO) <br />REGISTRATION/PERMITTING RENEWAL FORM <br />Owner Name: <br />Laura Padilla <br />Please check what type of water source is being used at the CFO: <br />□ City Water 0 Private Well* <br />Telephone: <br />209-278-7572 <br />Date: <br />10/08/2025 <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 />/p/fp/zC <br />SANJOAQUIN <br />------COUNTY------- <br />Greatness grows here.