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eR 2sool 2 co <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.orq/EHD <br />SAN JOAQUIN 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 />Rosotix Roma Desai <br /> <br />02/25/2025 <br />CFO Physical Address: CFO City: CFO Zip: <br />2458 Cordelia Lane Tracy 95377 <br />Website (If applicable): Telephone: <br />www.rosotix.conn 408-364-6227 <br />Categories: (c)ro c/‘ cyso-4---• x. <br /> <br />E "Class A" (Direct Sales Only) $186 V "Class B" (Direct & Indirect Sales) $486 <br />Prohibited Items: Initial if you agree to abide by the following: /eekna. <br /> <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. <br />"Class A" Self Certification Checklist: <br />0 Checklist completed ("Class A" CFOs Only) <br />Products: <br />Please check the items you will be preparing and/or selling. <br />Baked Goods <br />Candy <br />Li Churros <br />LII Buttercream <br />Frosting/Icing* <br />0 Dried Mole Paste <br />Fruit Empanadas <br />El Granola/Cereals <br />0 Cotton Candy <br />0 Dried Pasta <br />Dry Baking Mixes <br />0 Waffle Cones <br />Buttercream <br />Fondant/Gumpaste* <br />0 Herb/Spice Blends <br />Fruit Tamales/Pies <br />Seasoning Salt <br />0 Candied Apples <br />0 Honey <br />Mustard <br />E Dried Grain Mixes <br />0 Flat Icing <br />Li Pizzeles <br />111 Nut Mixes/Nut <br />Butters <br />Trail Mix/ Dried Fruit <br />Li Salted <br />Caramel/Fudge <br />Li Popcorn/ <br />Popcorn Balls <br />0 Vinegar <br />Fruit Butter** <br />Li Ground <br />Chocolate <br />Li Jams/Jellies** <br />Fried or Baked <br />Donuts and <br />Waffles <br />Dried Fruit <br />Marshmallows/ <br />Marshmallow <br />Bars* <br />END 16-27 6/29/2023 CFO REG/PERMITTING FORM <br />c})-1,v=E- scA s )L-1 S-7 I \di