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fi2Isoo9v-1 <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: vvww.sigov.orq/EHD <br />fNee,&, <br />elQ <br /> <br />COTTAGE FOOD OPERATIONS (CFO) <br />REGISTRATION/PERMITTING FORM <br />(CALIFORNIA HOMEMADE FOOD ACT AB 1616 (GATTO)) <br /> <br />CFO Business Name: Little oven Owner Name Lubna Sahikh <br /> <br />Date: 04/10/25 <br />CFO Physical Address: 4066 W Fauna Ave <br /> CFO City: Mountain House <br /> CFO Zip:95391 <br />Website (If applicable): Telephone: (510)371-1310 <br />Categories: <br />ei "Class A" (Direct Sales Only) $186 El "Class B" (Direct & Indirect Sales) $486 <br />2. Prohibited Items: Initial if you agree to abide by the following: i s <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 />vi§] Checklist completed ("Class A" CFOs Only) <br />Products: <br />Please check the items you will be preparing and/or selling. <br />Baked Goods <br />I=1 Candy <br />I=1 Churros <br />1E1 Buttercream <br />Frosting/Icing* <br />0 Dried Mole Paste <br />111 Fruit Empanadas <br />D Granola/Cereals <br />0 Cotton Candy <br />El Dried Pasta <br />El Dry Baking Mixes <br />111 Waffle Cones <br />111 Buttercream <br />Fondant/Gumpaste* <br />111 Herb/Spice Blends <br />El Fruit Tamales/Pies <br />0 Seasoning Salt <br />El Candied Apples <br />El Honey <br />111 Musta rd <br />El Dried Grain Mixes <br />C] Flat Icing <br />El Pizzeles <br />1=1 Nut Mixes/Nut <br />Butters <br />111 Trail Mix/ Dried Fruit <br />111 Salted <br />Caramel/Fudge <br />El Popcorn/ <br />Popcorn Balls <br />El Vinegar <br />CI Fruit Butter** <br />El Ground <br />Chocolate <br />El Jams/Jellies** <br />Fried or Baked <br />111 Donuts and <br />Waffles <br />111 Dried Fruit <br />Marshmallows/ <br />111 Marshmallow <br />Bars* <br />END 16-27 6/29/2023 1 CFO REG/PERMITTING FORM