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Example: <br /> BIG CAKE BAKER <br /> Stockton CA 952C9 <br /> Perm it#012345 <br /> slued n: San Joaquin County <br /> Chocolate Chip Cookies with Walnuts <br /> Ingredients:Enrichedflour twheatflaur,niacin,reduced iron,thiamine,moncnitrate,riboflavin <br /> and fdit acid),butter(milk,salts,chocolatechips[sugar,chocolate liquor,cocoa butter,butterfat <br /> [milk),walrus,sugar,eggs,salt,artificial vanilla wtract,baking soda <br /> Contains: Wheat, milk, eggs, soy, walnuts <br /> Made in a home kitchen <br /> Net Wt. 3 oz. (85.05g) <br /> Note.For the'Issued in County'-Identity the jurisdiction(city/county)where you are obtaining approval_ <br /> 6. Disposal of Waste: <br /> Please check what type of treatment is used to dispose of waste <br /> ❑ Public Sewer Service [,�3 Private Septic System <br /> In the event of septic system failure or plumbing problem,you are required to notify San Joaquin County Environmental Health <br /> Department immediate{y. <br /> 7. Water Source: <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 District: �2 of <br /> n <br /> ❑ Private Water Supply**, Identify the source (well, spring, surface, etc.): <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 /> ❑ Bacteriological Test (quarterly*): <br /> ❑ Nitrate Test (yearly*): <br /> EHD 16-27&2912023 4 CFO REG/PERMITTING FORM <br />