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   CCDEH Model CFO Registration/Permitting Form (Updated 12‐21‐2012)                                     Page 1 of 5  <br />  <br />ALAMEDA COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />CALIFORNIA HOMEMADE FOOD ACT AB 1616 (GATTO) <br />REGISTRATION / PERMITTING FORM <br /> <br />CFO Business Name: <br /> <br />Date: <br /> <br />CFO Physical Address: <br /> <br />CFO City: <br /> <br />CFO ZIP: <br /> <br />Owner Name: <br /> <br />Owner Phone: <br /> <br />Owner Cell: <br /> <br />Mailing Address (if different): <br /> <br />Mailing City: <br /> <br />Mailing ZIP: <br /> <br />Email Address: <br /> <br />Website: <br /> <br /> <br />1. Categories: <br /> <br /> “Class A” (Direct Sales Only) “Class B” ( Direct & Indirect Sales) <br /> <br />2. Prohibited Items: Initial if you agree to abide by the following: ________ <br /> <br />Foods containing cream, custard, or meat fillings are potentially hazardous and are NOT <br />ALLOWED. Only foods that are defined as “non-potentially hazardous” are approved for <br />preparation by a Cottage Food Operation (CFO). These are food items that do not require <br />refrigeration to keep them safe from bacterial growth that could be a cause of food-borne illness. <br /> <br />3. “Class A” Self Certification Checklist: <br /> <br /> Checklist completed (“Class A” CFOs Only)