Laserfiche WebLink
□“Class B" (Direct & Indirect Sales) $486 <br />3. <br />2 Baked Goods □ Dried Pasta □ Honey □ <br />□Candy □ Mustard <br />Churros EJ Dried Grain Mixes Fruit Butter** <br />-Eb, Flat Icing <br />□Dried Mole Paste □ Pizzeles □ Jams/Jellies** <br />□Fruit Empanadas □ Fruit Tamales/Pies <br />□Granola/Cereals □ Seasoning Salt <br />□Cotton Candy'□ Candied Apples <br />EHD 16-27 6/29/2023 1 CFO REG/PERMITTING FORM <br />Yft-2S 00 <br />Buttercream <br />Frosting/lcing* <br />Qn Dry Baking Mixes <br />□ Waffle Cones <br />Salted <br />Caramel/Fudge <br />Nut Mixes/Nut <br />Butters <br />Ground <br />Chocolate <br />Popcorn/ <br />Popcorn Balls <br />□ Vinegar <br />Date: <br />CFO Zip: <br />CFO Business Name: <br />CFO Physical Address: <br />1. Categories: <br />"Class A” (Direct Sales Only) $186 <br />“Class A” Self Certification Checklist: <br />S' Checklist completed ("Class A" CFOs Only) <br />r-i Buttercream <br />Fondant/Gumpaste* <br />□ Herb/Spice Blends <br />4. Products: <br />Please check the items you will be preparing and/or selling. <br />COTTAGE FOOD OPERATIONS (CFO) <br />REGISTRATION/PERMITTING FORM <br />(CALIFORNIA HOMEMADE FOOD ACT AB 1616 (GATTO)) <br />Owner Name: <br />VtXtJhYiA CnWLici <br />: r-nys.ua! naoress: CF0 Cjty; <br />Website (If applicable): Telephone: <br />San Joaquin County <br />Environmental Health Department <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.siqov.org/EHD <br />Fried or Baked <br />□ Donuts and <br />Waffles <br />□ Trail Mix/ Dried Fruit Dried Fruit <br />Marshmallows/ <br />Gh Marshmallow <br />Bars* <br />2' Prohibited Items: initial if you agree to abide by the following: Y^] <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 />orowth'that "T d0 001 refri9erati0" to them safe from <br />growth that could be a cause of food-borne illness.