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□ "Class B" (Direct & Indirect Sales) S436 <br />□□HoneyBaked Goods <br />Dry Baking Mixes □□ VinegarMustardCandy <br />□□ Fruit Butter**□ Waffle Cones Dried Grain Mixes□Churros <br />□□□Flat Icing□ <br />□□ Jams/Jellies**□ Herb/Spice Blends Pizzeles□Dried Mole Paste <br />□□ Fruit Tamales/Pies□Fruit Empanadas <br />□ Seasoning Salt Trail Mix/ Dried Fruit Dried Fruit <br />Candied Apples□Cotton Candy <br />CFOREG/Pf RMiniNGFORMIEHD 16-27 0/29/2023 <br />1. Categories: <br />E7” "Class A" (Direct Sales Only) SI86 <br />Buttercream <br />Frosting/lcing* <br />COTTAGE FOOD OPERATIONS (CFO) <br />REGISTRATION/PERMITTING FORM <br />(CALIFORNIA HOMEMADE FOOD ACT AB 1616 (GATTO)) <br />Buttercream <br />Fondant/Gumpaste’ <br />Nut Mixes/Nut <br />Butters <br />Marshmallows/ <br />□ Marshmallow <br />Bars* <br />Popcorn/ <br />Popcorn Balls <br />Ground <br />Chocolate <br />Tried or Baked <br />Donuts and <br />Waffles <br />San Joaquin County <br />E NVIRONMI N I Al I II Al III Dl PAR I ME NT <br />1868 I ast Hazelton Avenue, Stockton, CA 95205 6232 <br />Te/ephone. (209) 468-3420 Fax: (209) 464 0138 Wed: w/zw sjgov orfl/EHD <br />Date <br />|| -10 - <br />CFO Zip <br />A53V3- <br />APzibz.sss' <br />Dried Pasta <br />2. Prohibited Items: 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 />3. “Class A” Self Certification Checklist: <br />H^hecklist completed ("Class A" CFOs Only) <br />Salted <br />u Caramel/Fudge <br />Owner Name . <br />Gt on I <br />CFO City <br />Telephone sio-HiM-nyu i__ <br />CFO Business Naint ,. i • <br />Xr<n V? a ck ere i <br />CFO Physical Address <br />11 Quomp COCsy <br />Website (If applicable) <br />4. Products: <br />Please check the items you will be preparing and/or selling. <br />Granola/Cereals <br />LU