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Example of label: <br />Chocdate Chp Cookies wih Walnuts <br />Contains: Wheat, milk, eggs, soy, walnuts <br />Note. For the 'Issued in County’ - Identify the junsdiction (city/county) where you are obtaining approval <br />7. Water Source: <br />Private Water Supply**, Identify the source (well, spring, surface, <br />Bacteriological Test (quarterly*): <br />Nitrate Test (yearly*): <br />Nitrite Test (every 3 years*): <br />CFO REG/PERMITTING FORMEHD 16-27 6/29/2023 5 <br />6. Disposal of Waste: <br />Please check what type of treatment is used to dispose of waste <br />Public Sewer Service Private Septic System <br />ngredients: Enriched flour (wheat flour, niacin, reduced iron, thiamine, mononitrate, riboflavin, and folic acid), butter (milk, salt), <br />chocolate chips (sugar, chocolate liquor, cocoa butter, butterfat (milk), walnuts, sugar, eggs, salt, artificial vanilla extract, baking soda <br />In the event of septic system failure or plumbing problem, you are required to notify San Joaquin County Environmental <br />Health Department immediately. <br />Made in a Home Kitchen <br />Net Wt. 3 oz (85.05g) <br />Stockton CA ZIP CODE <br />PR#0000000 <br />Issued in: San Joaquin County <br />Private Water Supply: Initial Water Quality Results <br />Check boxes below if initial water testing has been completed. <br />All testing must be done at a State Certified Laboratory. Either attach lab results or provide name of lab, date & <br />results in space provided next to type of test. <br />‘(Testing frequency for transient Non-Community Water Systems after initial testing) <br />.Pease Identify the water source to be used in Cottage Food Facility (check one box) <br />Name of Public Water System or Community Services L-OCJl