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2096934145 p.88-May-2025 13:42 Marsha Nandani Raj <br />Th?. foHaw/ng reqw&ments are oMne'Jin ths Cottage rood Operations (CFO) regdethns and are provided as rriKmum sfandards <br />of hcattf) ano safety for the preparation of approved cotiape foods tri the home. <br />Facility Requirements:No <br />1. <br />3 Additional storage used for tha CFO will be within the home. <br />a <br />ci4 <br />No <br />Employee and Training Requirements:NoYes <br />If YES, copes of certificates are attacheda. <br />b. <br />Sanitation Requirements;Yes NO <br />G?/ □ <br />0' <br />EHD 16-26 1327/2012 3 CFO CtASS A CHECK) (ST <br />Yes <br />Yes <br />! 6. Have all persons preparing or packaging CrO products completed the CDPH food <br />processor course? <br />10. All food preparation and food and equipment storage areas shail be maintained free of <br />rodents and insects. <br />COTTAGE FOOD OPERATIONS (CFOs-CLASS A) <br />SELF CERTIFICATION CHECKLIST <br />San Joaquin County <br />Environmental Health Department <br />1868 East Hazelton Avenue, Stockton, CA S5205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 VYebr VAW.sigov.orq/ehd <br />CFO Owner Name: <br />Chary Pandey <br />CFO City <br />Lodi <br />0 <br />i CFO ZIP. <br />=95240 <br />i <br />Zoning Requirements: <br />; 5. I have complied with the applicable zoning requirements for the CFO. <br />CrO Business Nane. <br />. Fhteen Slices LLC <br />CFO Address: <br />916 Calsvers Street <br />The CFO is located in a pnvate dwelling where the CFO operator currently resides <br />2. All CFO food preparation will take place in the private kitchen within that home. <br />If NO, complete course within 3 months of CFO registration. <br />7. The CFO has no more than 1 full-time equivalent employee? (Immediate family or <br />household members are not included.) <br />If YES, is the room used exclusively for storage? O <br />b. Specify the room(s) that will be used for storage? SV^L\t- -y"7ld-^ <br />Sleeping quarters are excluded from areas used for CFO food preparation or storage <br />9. All food contact surfaces, equipment, and utensils used for the preparation, packaging, <br />or handling of any CFO products shall be washed, rinsed, and sanitized before each <br />Use. <br />8. Kitchen equipment and utensils used to produce CFO products are clean and <br />maintained in a good state of repair