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LLG <br />Mo <br />40^ - ~l - ofarm <br />“Class A" (Direct Sales Only) $186 “Class B" (Direct & Indirect Sales) $486 <br />4. Products: <br />Please check the items you will be preparing and/or selling. <br />0^Honey Dried PastaBaked Goods <br /> Dry Baking MixesCandy Mustard <br /> Waffle Cones Fruit Butter’Churros Dried Grain Mixes <br />Flat Icing <br /> Herb/Spice Blends Jams/Jellies**Dried Mole Paste Pizzeles <br /> Fruit Tamales/PiesFruit Empanadas <br /> Trail Mix/ Dried Fruit Dried Fruit Seasoning SaltGranola/Cereals <br /> Candied ApplesCotton Candy <br />1 CFO REG/PERMITTING FORMEHD 16-27 6/29/2023 <br />Buttercream <br />Frosting/lcing* <br />Buttercream <br />Fondant/Gumpaste* <br />Nut Mixes/Nut <br />Butters <br />Ground <br />Chocolate <br />•Fried or Baked <br />Donuts and <br />Waffles <br />COTTAGE FOOD OPERATIONS (CFO) <br />REGISTRATION/PERMITTING FORM <br />(CALIFORNIA HOMEMADE FOOD ACT AB 1616 (GATTO)) <br />Date <br />CFO Zip: <br />'15 I <br />Owner Name: <br />Rfdrill <br />CFO City: <br />UM/mu <br />Telephone: <br />Popcorn/ <br />Popcorn Balls <br /> Vinegar <br />_ Marshmallows/ <br /> Marshmallow <br />Bars* <br />CFO Business Name: <br />CFO Physical Address: <br />58^ Dutt fin <br />Website (If applicable): <br />hl Vxl h/ * XC Hdrj C » <br />1. Categories: <br />3. “Class A” Self Certification Checklist: <br />Q^Checklist completed (“Class A" CFOs Only) <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 sjgoy.prg/EHD <br />pZ Salted <br />Caramel/Fudge <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. o v <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 />flex%