Laserfiche WebLink
S <br /> d ,, SANJOAQUIN Environmental Health Department. <br /> jw" —CCDUN T Y— <br /> °a� ylGx;7?'ASS f'r0'h5f.Nf'Ej• - u�1L�� (�,' ��� <br /> COTTAGE FOOD OPERATIONS (CFO) JUL 12 1011 <br /> ENVIRONME <br /> 11 <br /> REGISTRTON/PERMITTING FORM(CALIFORNIA HOMEMIAADE FOOD ACT AB 16116 GATTO))MIT/SERVIDES�TH <br /> /CFO Business Name: Owner Name: \n^- Date: <br /> CFO Physical Address: /� `` 11 CF,O�Ci/ty: CFO <br /> Zip: <br /> St � tl---1. 1Y Y \GFYl CLl,� \Y-t LJ L��7 <br /> Website(If applicable): Telephone: <br /> 1��. Categories: <br /> l� "Class A" (Direct Sales Only)$155 ❑ "Class B"(Direct& Indirect Sales)$310 <br /> 2. `Prohibited Items: Initial if you agree to abide by the following: OVA . <br /> Foods containing cream, custard, or meat fillings are potentially hazardous and are NOT ALLOWED. Only <br /> foods that are defined as "non-potentially hazardous' are approved for preparation by a Cottage Food Operation. <br /> These foods include items that do not require refrigeration to keep them safe from bacterial growth that could be a <br /> cause of food-borne illness. <br /> 3. "Class A" Self Certification Checklist: <br /> ❑ Checklist completed ("Class A"CFOs Only) <br /> 4. Products: <br /> Please check the items you will be preparing and/or selling. <br /> Baked Goods El Dried Pasta El Honey El Popcorn <br /> Popcorn Balls <br /> ❑ Candy J Dry Baking Mixes ❑ Mustard ❑ Vinegar <br /> ❑ Churros ❑ Waffle Cones ❑ Dried Grain Mixes ❑ Fruit Butter** <br /> ❑ Buttercream ❑ Buttercream E] Flat Icing ❑ Ground <br /> Frosting/Icing* Fondant/Gumpaste* Chocolate <br /> ❑ Dried Male Paste Herb/Spice Blends ❑ Pizzeles ❑ Jams/Jellies** <br /> Nut Mixes/Nut Fried or Baked <br /> ❑ Fruit Empanadas Fruit Tamales/Pies ❑ Butters ❑ Donuts and <br /> Waffles <br /> ❑ Granola/Cereals ❑ Seasoning Salt ❑ Trail Mix/Dried Fruit ❑ Dried Fruit <br /> Salted Marshmallows/ <br /> ❑ Cotton Candy ❑ Candied Apples ❑ El Marshmallow <br /> Caramel/Fudge Bars* <br /> Dried or Dehydrated Dried Vegetarian- <br /> ❑ Vegetables ElDried <br /> Soup Mixes E] Vegetable and Potato Chips <br /> 1868 E. Hazelton Avenue Stockton, California 95205.1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/EHD <br />