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Website (If applicable): <br />1. Categories: <br />□“Class A” (Direct Sales Only) $186 “Class B” (Direct & Indirect Sales) $486 <br />2. Prohibited Items: <br />3. “Class A” Self Certification Checklist: <br />[XI Checklist completed (“Class A" CFOs Only) <br />4. Products: <br />Please check the items you will be preparing and/or selling. <br />□□□Baked Goods Dried Pasta Honey <br />□□□0 VinegarCandyDry Baking Mixes Mustard <br />□□ Fruit Butter**□□Churros Waffle Cones Dried Grain Mixes <br />□□□□Flat Icing <br />□□ Jams/Jellies**□□Herb/Spice Blends PizzelesDried Mole Paste <br />□□□Fruit Tamales/PiesFruit Empanadas <br />□□ Dried Fruit□□Trail Mix/ Dried FruitGranola/Cereals Seasoning Salt <br />□□□Candied ApplesCotton Candy <br />1 CFO REG/PERMITTING FORMEHD 16-27 6/29/2023 <br />Popcorn/ <br />Popcorn Balls <br />Buttercream <br />Frosting/lcing* <br />Buttercream <br />Fondant/Gumpaste* <br />Salted <br />Caramel/Fudge <br />Nut Mixes/Nut <br />Butters <br />Ground <br />Chocolate <br />COTTAGE FOOD OPERATIONS (CFO) <br />REGISTRATION/PERMITTING FORM <br />(CALIFORNIA HOMEMADE FOOD ACT AB 1616 (GATTO)) <br />San Joaquin County /A oo 5 2 "S. <br />Environmental Health Department <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 IVeb: www.siqov.org/EHD <br />0 <br />CFO Business Name: <br />B's Sourdough <br />CFO Physical Address: <br />17983 Isabella Place <br />Owner Name: <br />Cierra Zapata <br />CFO City: <br />Lathrop <br />Telephone: <br />650-303-4370 <br />Date: <br />05/13/2025 <br />CFO Zip: <br />95330 <br />Marshmallows/ <br />□ Marshmallow <br />Bars* <br />Fried or Baked <br />□ Donuts and <br />Waffles <br />Initial if you agree to abide by the following: cz <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.