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Example: <br />CFO REG/PERMITTING FORM4EHD 16-27 6/29/2023 <br />6 Disposal of Waste: <br />^se CecX type of tre^ent is useP to <br /> Public Sewer Service <br />Department immediately. <br />we-For lhe in County - i^fy iPeju^nn ^cnunty) nre lining npp^i. <br />7. Water Source: <br />Pease Identify the water source to be used in Cottage Food Facility (check one box) <br /> Name of Public Water System or Community Services District: <br />0 Private Water Supply**. Identify the source (well, spring, surface, etc.): <br />Private Water Supply: Initial Water Quality Results <br />'*■ da'e & <br />results in space provided next to type of test. . <br />‘(Testing frequency for transient Non-Community Water Systems after initial testing) <br />KJ Bacteriological Test (quarterly*): <br />[X Nitrate T est (yearly*): <br />BIG CAKE BAKER <br />Stockton CA 95209 <br />Permit# 012345- - ~ <br />Issuedin: San Joaquin County > \ <br />Chocolate Chip Cookies with Walnuts <br />-*• *”*' <br />^Contains: Wheat, milk, eggs, soy. w3lniJts <br />Made in a home kitchen <br />Net Wt. 3 oz. (85.05g) v D