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P^25CD7^O I o 1. Categories: □“Class B” (Direct & Indirect Sales) $486“Class A” (Direct Sales Only) $186 2. Prohibited Items: 4. Products: Please check the items you will be preparing and/or selling. □□□HoneyDried PastaBaked Goods □□ Vinegar□□MustardDry Baking MixesCandy □□ Fruit Butter**□□Dried Grain MixesWaffle ConesChurros □□□□Flat Icing □□□PizzelesHerb/Spice BlendsDried Mole Paste □□□Fruit Tamales/PiesFruit Empanadas □□ Dried Fruit□□Trail Mix/ Dried FruitSeasoning SaltGranola/Cereals □□□Candied ApplesCotton Candy i CFO REG/PERMITTING FORMEHD 16-27 6/29/2023 Buttercream Frosting/lcing* COTTAGE FOOD OPERATIONS (CFO) REGISTRATION/PERMITTING FORM (CALIFORNIA HOMEMADE FOOD ACT AB 1616 (GATTO)) Buttercream Fondant/Gumpaste* Salted Caramel/Fudge Nut Mixes/Nut Butters Ground Chocolate Popcorn/ Popcorn Balls Owner Name: Date: CFO City: CFO Zip: Telephone: /pi __ Fried or Baked □ Donuts and Waffles Marshmallows/ □ Marshmallow Bars* 3. “Class A” Self Certification Checklist: ■Q^Checklist completed (“Class A” CFOs Only) . V CFO Business Name: PKILLAV BAKEty CFO Physical Address: 2-1 g 5 l EJAS L ArVt Website (If applicable): Initial if you agree to abide by the following: 'p Foods containing cream, custard, or meat fillings are potentially hazardous and are NOT ALLOWED Only foods that are defined as “non-potentially hazardous” are approved for preparation by a Cottage Food Operation. These foods include items that do not require refrigeration to keep them safe from bacterial growth that could be a cause of food-borne illness. San Joaquin County Environmental Health Department 1868 East Hazelton Avenue, Stockton, CA 95205-6232 z5Q£)T7O Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.siqov.org/EHD □ Jams/Jellies**