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"Class B” (Direct & Indirect Sales) S486 <br />fruit butters include a list of <br />SAN JOAQUIN <br />county <br />here <br />6. Food Processor Course: <br />Attach food handler certification for owner and each individual that were not submitted with initial application <br />(including family members and/or employees). <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420) F 209 464-0138 | www.sjcehd.com <br />5. Water Source: <br />Please check what type of water source is being used at the CFO: <br />[^City Water □ Private Well* <br />’If a private well, attach all updated water sample results (including quarterly bacteria and Nitrate results.) <br />4. Product Labeling: <br />Attach two labels to this form for two of your CFO products (only <br />made). <br />CFO City <br />_______ <br />one label is required if only one product is <br />COTTAGE FOOD OPERATIONS (CF0> <br />REGISTRATION/PERMITTING RENEWAL FORM <br />CFO Zip <br />1. Categories: <br />"Class A" (Direct Sales Only) SI86 <br />3. Products: <br />Provide a list of all products you are preparing. If preparing jams, jellies, or <br />ingredients (attach separate page if needed). <br />Food List: ( <br />______CCflwaWlQKk pAls______________________ <br />Environmental Health Department <br />• A A-2. Prohibited Items: Initial if you agree to abide by the follow, <br />Foods containing cream, custard, or mealby a Cottage Food Operation <br />to keep them safe from bacter.at growth that coutd be a <br />cause of food-borne illness <br />CFO Business Name <br />CFO Physical Address <br />\fj03O <br />Website (It applicable)