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4. Products: <br />Please check the items you will be preparing and/or selling. <br />Ba ked Goods 0 Dried Pasta <br /> O Honey <br />LI Candy fAfr-Dry Baking Mixes <br />,;lhurros LI Waffle Cones <br />Buttercream n Buttercream <br />Frosting/Icing* Fondant/Gumpaste* <br />10 Dried Mole Paste 0 Herb/Spice Blends <br />Mustard <br />0 Dried Grain Mixes <br />Flat Icing <br />LI Pizzeles <br />E Trail Mix/ Dried Fruit <br />az/S/alted <br />Caramel/Fudge <br />Dried Fruit <br />Marshmallows/ <br />LI Marshmallow <br />Bars* <br />1 CFO REG/PERMITTING FORM <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East HazeIton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.siciov.orq/EHD <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 />Mabuhay Grindz Christina Degala 06/10/2024 <br />CFO Physical Address: CFO City: CFO Zip: <br />1622 Dooston Ave. Tracy, CA 95377 <br />Website (If applicable): Telephone: <br />408-913-3930 <br />Categories: <br />E "Class A" (Direct Sales Only) $186 E "Class B" (Direct & Indirect Sales) $486 <br />2. Prohibited Items: Initial if you agree to abide by the following: C <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 />"Clas A" Self Certification Checklist: <br />hecklist completed ("Class A" CFOs Only) <br />1-3,-Popcorn/ <br />Popcorn Balls <br />Vinegar <br />Fruit Butter** <br />round <br />,J217Chocolate <br />0 Jams/Jellies** <br />ut Mixes/Nut <br />utters 0 Fruit Empanadas <br />)2/ Granola/Cereals <br />Cotton Candy <br />END 16-27 6/29/2023 <br />Fruit Tamales/Pies <br />0 Seasoning Salt <br />Candied Apples <br />ted or Baked <br />„„Ernuts and <br />Waffles