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^2^003^3 <br />Environmental Health Department <br />On <br />cro&MwNam* Sri Varahi Foods Own* Divya Maiireddi □rt. feb 7 2026 <br />oozo 95377 <br />5103713660WataMdfaRMKMM) <br /> ‘CUm B* (Direct & Indirect Satan> $486 <br />DM <br />JAMS, JELLIES, DEHYDRATED FRUIT BARS <br />•tf a pnvata wal. attach afl updated water eampte reedtt (mdudno quartarty bacterio and Ntralo reeuto ) <br />1. Cfoort—: <br />0 -Clan A* (Direct Saiee Only) $186 <br />4. Product LibtlinQ; <br />Attach two labota to th* form tor two of your CFO products (only one label« requrod only one product ■ <br />made). <br />PO Pnwca mow 2510 Ro Grande Cfootr Tracy <br />dr <br />COTTAGE FOOD OPERATIONS (CFO) <br />REGISTRATVONMRMITnNG RENEWAL FORM <br />2. Prohibited Harm: Mttal If you agree to abMa by the Mowing: <br />Foods contanng cream, custard, or meet fNOnga are potenttaily hazardous and are MOT ALLOWED Only <br />foods that are defined as ‘norvpotenhally hazardous* are approved for preparation by a Cottaqe Food Operason <br />These foods mdude items that do not require refngerotion to Keep them safe from bacter ai growth that could be a <br />cause of food-bome aness. <br />Attach food handler certAcaSon for owner and each mdMdual that were rat submttted with rwsai apptcation <br />(including tamtty members andfor employees) <br />1868 E Hazelton Avenue | Stockton, California 95205 | T 209 468-34201 F 200 464-0’36 I www Bjcehd ccrn <br />SAN JOAQUIN <br />-----COUNTY------ <br />x Producti; <br />Provtoe a list of al products you are preparing If preparing jams, jefees. or frul butters inctode a fist of <br />ngrediertts (attach separate page if needed) <br />Food L*t <br />& Water Souret; <br />Rease chec* whaf type of wafer scarce a beng used afttie CFO <br />S City Water Private WeT