Laserfiche WebLink
,U t.. c..0 <br />.4 I'- <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.smov.oro/EHD <br />COTTAGE FOOD OPERATIONS (CFO) I <br />REGISTRATION/PERMITTING FORM <br />(CALIFORNIA HOMEMADE FOOD ACT AB 1616 (GATTO)) <br />tuAtt'lmirir <br />.01.01 2/ <br />6 Ptc0"4"1 <br />tu'd <br />rvv!4-1i- v\P'4 <br />CFO Business Name: <br />fiP/ nai /CS- <br />CFO Physical Address: <br /> <br />Owner Name: Date: <br />M ANA" L421- L c, <br />CFO City: CFO Zip: <br />tv1cQt 1 <br />Telephone: <br />t' 44 2C' ..rt, 21 <br /> <br />Website (If applicable): <br /> <br />Categories: <br />{-,71/ "Class A" (Direct Sales Only) $186 0 "Class B" (Direct & Indirect Sales) $486 <br />Prohibited Items: Initial if you agree to abide by the following: <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 />LI Checklist completed ("Class A" CFOs Only) <br />Products: <br />Please check the items you will be preparing and/or selling. <br />A <br />Popcorn/ <br />Popcorn Balls <br />El Candy <br />LI Churros <br />LI Buttercream <br />Frosting/Icing* <br />LI Dried Mole Paste <br />0 Fruit Empanadas <br />El Granola/Cereals <br />0 Cotton Candy <br />LI Dry Baking Mixes <br />Waffle Cones <br />Buttercream <br />Fonda nt/Gumpaste* <br />r] Herb/Spice Blends <br />El Fruit Tamales/Pies <br />El Seasoning Sall <br />Candied Apples <br />LI Mustard <br />0 Dried Grain Mixes <br />Flat Icing <br />fl Pizzeles <br />n Nut Mixes/Nut <br />I-1 Butters <br />Trail Mix/ Dried Fruit <br />n Salted <br />Caramel/Fudge <br />LI <br />Vinegar <br />Fruit Butter** <br />LI Ground <br />Chocolate <br />Jams/Jellies <br />Fried or Baked <br />LI Donuts and <br />Waffles <br />LI Dried Fruit <br />Marshmallows/ <br />Marshmallow <br />Bars* <br />0 Baked Goods D Dried Pasta D Honey <br />LI <br />EHD 16-27 6/29/2023 CFO REG/PERMITTING FORM <br />PR25003S1