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Salted <br />Caramel/Fudge CI <br />SAN JOAQUIN <br /> <br />Environmental Health Department <br />- COUNTY - <br />COTTAGE FOOD OPERATIONS (CFO) <br />REGISTRATION/PERMITTING FORM <br />(CALIFORNIA HOMEMADE FOOD ACT AB 1616 (GATTO)) <br />CFO Business Name: Owner Name: Date: <br />The ART of Food Audrey Thomas 04/18/2024 <br />CFO Physical Address: CFO City: CFO Zip: <br />8700 West Lane SPC 279 Stockton <br /> 95210 <br />Website (If applicable): Telephone: <br />209-954-8235 <br />Categories: <br />12 "Class A" (Direct Sales Only) $186 <br /> El "Class B" (Direct & Indirect Sales) $312 <br />2. Prohibited Items: Initial if you agree to abide by the following: A 7- <br />Foods containing cream, custard, or meat fillings are potentially hazardous and are NOT ALLOWED. Only foods <br />that are defined as "non-potentially hazardous" are approved for preparation by a Cottage Food Operation. These <br />foods include items that do not require refrigeration to keep them safe from bacterial growth that could be a cause of <br />food-borne illness. <br />"Class A" Self Certification Checklist: <br />El Checklist completed ("Class A" CFOs Only) <br />Products: <br />Please check the items you will be preparing and/or selling. <br />Popcorn/ <br />Popcorn Balls 121 Baked Goods <br />El Candy <br />1:11 Churros <br />Buttercream <br />Frosting/Icing* <br />LI Dried Mole Paste <br />D Fruit Empanadas <br />El Granola/Cereals <br />El Cotton Candy <br />El Dried Pasta <br />El Dry Baking Mixes <br />El Waffle Cones <br />Buttercream <br />Fondant/Gumpaste* <br />111 Herb/Spice Blends <br />[1 Fruit Tamales/Pies <br />El Seasoning Salt <br />IS:1 Candied Apples <br />El Honey 1=1 <br />El Mustard El Vinegar <br />El Dried Grain Mixes El Fruit Butter** <br />El Flat Icing El <br />El Pizzeles El Jams/Jellies** <br />Fried or Baked <br />CI Donuts and <br />Waffles <br />El Trail Mix/ Dried Fruit El Dried Fruit <br />Marshmallows/ <br />D Marshmallow <br />Bars* <br />Ground <br />Chocolate <br />El <br />Nut Mixes/Nut <br />Butters <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sjgov.org/ehd <br />1-)ROSLILogt