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•ft? 2^01 512 <br />Owner Name: <br />A <br /> “Class B” (Direct & Indirect Sales) $486 <br />Baked Goods Dried Pasta Honey <br />Candy Mustard <br />Churros D Dried Grain Mixes <br /> Flat Icing <br /> Pizzeles Jams/Jellies** <br />Fruit Empanadas Fruit Tamales/Pies <br />Granola/Cereals Seasoning Salt <br />Cotton Candy Candied Apples <br />EHD 16-27 6/29/2023 1 CFO REG/PERMITTING FORM <br />\ c\\ GV V)C/4 Q g <br />?to(XI 2-^ <br />Buttercream <br />Frosting/lcing* <br />Dried Mole Paste <br /> Dry Baking Mixes <br /> Waffle Cones <br />Salted <br />Caramel/Fudge <br />Nut Mixes/Nut <br />Butters <br />Ground <br />Chocolate <br />CFO City: <br />Telephone: <br />- 6^^ - CqC)^^ <br />1. Categories: <br />& “Class A" (Direct Sales Only) $186 <br />Marshmallows/ <br /> Marshmallow <br />Bars* <br />Popcorn/ <br />Popcorn Balls <br /> Vinegar <br /> Fruit Butter** <br />Buttercream <br />Fondant/Gumpaste* <br /> Herb/Spice Blends <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.sjgov.org/EHD <br />COTTAGE FOOD OPERATIONS (CFO) <br />REGISTRATION/PERMITTING FORM <br />(CALIFORNIA HOMEMADE FOOD ACT AB 1616 (GATTO)) <br />CFO Business Name: <br />CFO Physical Address: <br />lb? ftctvyy ________ <br />Website (If applicable): <br />_____In <br />Fried or Baked <br /> Donuts and <br />Waffles <br /> Trail Mix/Dried Fruit Dried Fruit <br />CFO Zip: <br />/'I <br />3- “Class A” Self Certification Checklist: <br />Checklist completed (“Class A" CFOs Only) <br />2. Prohibited Items: initial if you agree to abide by the following: <br />4. Products: <br />Please check the items you will be preparing and/or selling.