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PR 2.4-1 ogstoo <br />Environmental Health Department <br />cit:1 <br />•••;,- • •:.41. - <br />SAN JCAOUIN <br />COTTAGE FOOD OPERATIONS (CFO) <br />REGISTRATION/PERMITTING RENEWAL FORM <br />CFO Business Name Owner Name Sugar meets Spice Date Patricia Morales and Anahse Nuno 6/24/24 <br />CFO Physical Address CFO City 367 N Union Rd Apt # 115 M CFO Zip Manteca <br />95337 <br />Webstte Of applicable) Telephone. <br />(209) 499-4606 <br />1. Categories: <br />...:ass A (arect Sales Only) $186 c] "Class B" (Direct & Indirect Sales) $486 <br />Prohibited Items: Initial if you agree to abide by the following: 1', <br />F000s co7:tamLna 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 />cause of food-borne illness These fooas include items that do not require refrigeration to keep them safe from bacterial growth that could be a <br />Products• <br />F-c :Joe a list of all products you are preparing. If preparing jams, jellies, or fruit butters include a list of ingredients (attach separate page if needed). <br />Cocoa powder, vanilla extract, strawberry extract, lemon juice, lemon extract, sun-dried tomatoes, pesto, mozzarella, balsamic vinegar, <br />spinach, feta, flour, unsalted butter, eggs, milk, sugar, powdered sugar, <br />baking powder, vegetable oil, vegetable shortening, black pepper, and <br />Fos: Ls! salt <br />Product Labeling: <br />Attach two labels to this form for two of your CFO products (only one label is required if only one product is made; <br />Water Source: <br />Please check what type of water source is being used at the CFO: <br />X City Water <br />LI Private Well* <br />If a private <br />well, attach all updated water sample results (including quarterly bacteria and Nitrate results.) <br />Food Processor Course: <br />Attach food handler certification for owner and each individual that were not submitted with initial application (including family members and/or employees). <br />-1658 E Hazelton Avenue I Stockton, California 95205 T 209 468-3420 F 209 464-0138 I www.sjcehd.com