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Environmental Health Department grows COTTAGE FOOD OPERATIONS (CFO) Website (If applicable): □“Class A" (Direct Sales Only) $186 “Class B” (Direct & Indirect Sales) $486 2. Prohibited Items: 3. Products: Food List: Baked Goods, Waffle Cones, Dry Baking Mixes, Salted Caramel, Fried or Baked Donuts and Waffles, Candy, Churros, Roasted Coffee Beans/Grounds 4. Product Labeling: 5. Water Source: *lf a private well, attach all updated water sample results (including quarterly bacteria and Nitrate results.) 6. Food Processor Course: 1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420) F 209 464-0138 | www.sjcehd.com Please check what type of water source is being used at the CFO: 0 City Water U Private Well* Attach two labels to this form for two of your CFO products (only one label is required if only one product is made). CFO Business Name: Kenzi Sweets / Maramia CFO Physical Address: 757 N Del Prado St Attach food handler certification for owner and each individual that were not submitted with initial application (including family members and/or employees). Initial if you agree to abide by the following: M.A. Foods containing cream, custard, or meat fillings are potentially hazardous and are NOT ALLOWED. Only foods that are defined as “non-potentially hazardous" are approved for preparation by a Cottage Food Operation. These foods include items that do not require refrigeration to keep them safe from bacterial growth that could be a cause of food-borne illness. Provide a list of all products you are preparing. If preparing jams, jellies, or fruit butters include a list of ingredients (attach separate page if needed). Owner Name: Maram Alomari CFO City: Mountain House Telephone: 510.833.3015 Date: 01/12/2026 CFO Zip: 95391 1. Categories: s SANJOAOUIN ------COUNTY------- Greatness grows here. I (---------- Vo CAcxrcA Mt^REGISTRATION/PERIVIITTING RENEWAL FORM