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SANJOAOUIN <br /> v. <br />6- <br />1. Categories: <br />r~•sj $310Class fi (Direct & Indirect Sjily)$155 <br />4. Products: <br />Please check the items you v/ill he preparing and/or selling <br />Dried Pasta HoneyBaked Goods L. <br />Lj VmeqarO Dry Baking Mixes MustaroCandy <br />Q Fruit butter”Dried Gram MixesWaffle ConesChurrosu <br />n Flat Icing <br />;~1LJ Herb/Sptce Blends Pizzeies Jams'Jellies”Dried Mole Paste <br />Fruit 1 amales/PiesFruit Empanadas <br />i'J Dnea FrudL' Seasoning Saltn Trail M^; Dried FruitGranola/Cereals <br />Cotton Cand>Candied Apples —I <br />Vegetable ano Potato Chips <br />Stockton CahKven h <br />Dried or Dehydrated <br />Vegetaoles <br />Buttercream <br />Frostrng/lcmn* <br />Buttercream <br />Fondant/Gumoastc* <br />Nut Mixes/Nut <br />Butters <br />Fried or Baked <br />Donuts and <br />Waffles <br />Popcorn <br />Popcorn Bails <br />Salteo <br />Caramel/Fudge <br />CFO Z<p <br />Dried Vegetanan- <br />Based Soup Mixes <br />Marshmallows <br />.J Marshmallow <br />Bars* <br />COTTAGE FOOD OPERATIONS (CFO) <br />REGISTRATION/PERMITTING FORM <br />(CALIFORNIA HOMEMADE FOOD ACT AB 1616 (GATTO)) <br />(—• Ground <br />1 Chocolate <br />3. “Class A” Self Certification Checklist: <br />X Checklist completed ( Class A CFOs Only) <br />Oah?' Name <br />A' <br />CFO City <br />__ Lz_ <br />t elepnono <br />(9 Tf J \ 3 <br />Environmental Health Departm* <br />\X <br />■“> 51 <br />CFO Business Name <br />, i / / 3 v 3(/_ 3 f__ <br />C/FO Phys'cal Address <br />/YaH' > T Si <br />We&srte (It applicable <br />s <br />I'fi <br />Class A (Direct Sail <br />Ad/lfl.t-/ ------------------- <br />2. Prohibited Items: Initial if you agree to abide by the following: <br />Foods containing cream, custard, or meat fillings are potentially hazardous ano are NOT ALLOWED Onr. <br />foods that are defined as "non-potentially hazardous are approved for preparation by a Cottage Food Operatin' <br />These foods include items that do not require refrigeration to keep them safe from oactena! growth that coulu o .• <br />cause of food-borne illness.