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"4" SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> <1 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> . �?;�• Telephone:(209)468-3420 Fax:(209) 484-0138 Web:www.Siaov.oralEHD <br /> COTTAGE FOOD OPERATIONS (CFO) <br /> REGISTRATION/PERMITTING FORM <br /> (CALIFORNIA HOMEMADE FOOD ACT AB 1616 (GATTO)) <br /> RainbowsprinklesTracy M0=24 <br /> 425GlenbrookDrive ----- .Tracy -� - - -- 953n <br /> 1. Categories: <br /> -Class A" (Direct Sales Only) $186 <br /> 2. Prohibited Ite s: initial if you agree to abide by the following:—Anu <br /> Foods containing cream, custard, or meat fillings are potentially hazardous and are NOT <br /> ALLOWED- Only foods that are defined as "non-potentially hazardous" are approved for preparation <br /> by a Cottage Food Operation. These foods include items that do not require refrigeration to Keep <br /> them safe from bacterial growth that could be a cause of food-bome illness. <br /> 3. "Class A" Self Certification Checklist: <br /> Checklist completed (`Class A" CFOs Only) <br /> 4. -Products' <br /> Please check the iterns you will he preparing and/or selling. <br /> Popcorn! <br /> Baked Goods Dried Pasta Honey Popcorn Balls <br /> Candy <br /> Dry Baking Mixes Mustard Vinegar <br /> Churros <br /> Waffle Cones Dried Grain Mixes Fruit Butter" <br /> Ground <br /> Buttercream 13uttercream Fondant/ Flat Icing Chocolate <br /> Frosting/Icing' Gumpaste' <br /> Dried Mole Paste Herb/Spice Blends <br /> Pizzeles jams/Jellies" <br /> Fried or Baked <br /> Nut Mixes/Nut Donuts and <br /> Fruit Empanadas Fruit TamaleslPies Butters Waffles <br /> seasoning Salt Trail Mix!Dried Dried Fruit <br /> Granola/Cereais Fruit <br /> t CFO REUpERMIMNG FORM <br /> EFiD 16-278R9f2023 <br />