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p.6+168131007105-May-Z0Z5 Zl:44 From: <br />Example: <br />i Contains: Wheat, milk, eggs, soy., walnuts- <br />Note: For the “Issued m County" - Identify the jurisdiction (dty/county) where you are obtaining approval. <br />6. Disposal of Waste: <br />7. Water Source: <br />4 CFO REG/PERMITTING FORMEHD 16-27 6/29/2023 <br />!i <br />Please check what type of treatment is used to dispose of waste <br />Public Sewer Service Private Septic System <br />In the event of septic system failure or plumbing problem, you are required to notify San Joaquin County Environmental Health <br />Department immediately. <br />Made in a home kitcheo <br />Net Wt. 3 oz. (S5.O5g) <br />BIG CAKE BAKER <br />Stockton CA 95235 <br />Perm it# 012345 <br />Jssu-ed Sn: Ssn Caiinty <br />Chocolate Chip Cookies with Walnuts <br />i it^i edienri ErsS’kheafleui {vsheacfl-ous. r-iadr, r-Juced iixsn. thiansine, mcnorkrars, i ibuflswn <br />: an®- fc-lic sszid;, outta.' (milk, salt*:, shcce-latechips feugar, -jhoc-alate liquor, axes butter, buttarfai <br />; imil^, walnut^ st^ar.eggs. ssit. ardfizislvanilla skratt, baling soda <br />Pease Identify the water source to be used in Cottage Food Facility (check one box) <br />C^fjame of Public Water System or Community Services District: city of Manteca <br /> Private Water Supply**, Identify the source (well, spring, surface, etc.): <br />Private Water Supply. Initial Water Quality Results <br />Check boxes below if initial water testing has been completed. <br />All testing must be done at a State Certified Laboratory. Either attach lab results or provide name of lab, date & <br />results in space provided next to type of test. <br />‘(Testing frequency for transient Non-Community Water Systems after initial testing) <br /> Bacteriological Tost (quarterly*): <br /> Nitrate Test (yearly*):