Laserfiche WebLink
Website (If applicable): <br />1. Categories: <br />□Class A” (Direct Sales Only) $186 "Class B" (Direct & Indirect Sales) $486 <br />P.T2. Prohibited Items: <br />4. Products: <br />Please check the items you will be preparing and/or selling. <br />□□□Dried Pasta HoneyBaked Goods <br />□ Vinegar□□□Dry Baking Mixes MustardCandy <br />□□ Fruit Butter**□□Waffle Cones Dried Grain MixesChurros <br />□□□Flat Icing <br />□O Jams/Jellies**□□PizzelesHerb/Spice BlendsDried Mole Paste <br />□□□Fruit Tamales/PiesFruit Empanadas <br />□□ Dried Fruit□□Trail Mix/ Dried FruitSeasoning SaltGranola/Cereals <br />□□□Candied ApplesCotton Candy <br />1 CFO REG/PERMITTING FORMEHD 16-27 6/29/2023 <br />CFO Business Name: <br />Paulina Bakes <br />Buttercream <br />Frosting/lcing* <br />Buttercream <br />Fondant/Gumpaste* <br />Nut Mixes/Nut <br />Butters <br />Salted <br />Caramel/Fudge <br />Popcorn/ <br />Popcorn Balls <br />Ground <br />Chocolate <br />COTTAGE FOOD OPERATIONS (CFO) <br />REGISTRATION/PERMITTING FORM <br />(CALIFORNIA HOMEMADE FOOD ACT AB 1616 (GATTO)) <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.siqov.org/EHD <br />CFO Physical Address: <br />314 W Lockeford St #A <br />Telephone: <br />818-425-3371 <br />CFO Zip: <br />95240 <br />Date: <br />07/01/2026 <br />Owner Name: <br />Paulina Thompson <br />CFO City: <br />Lodi <br />3. “Class A” Self Certification Checklist: <br />Checklist completed (“Class A” CFOs Only) <br />Fried or Baked <br />□ Donuts and <br />Waffles <br />Marshmallows/ <br />□ Marshmallow <br />Bars* <br />Initial if you agree to abide by the following: <br />Foods containing cream, custard, or meat fillings are potentially hazardous and are NOT ALLOWED. <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.