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“Class B” (Direct & indirect Sales) $486 <br />2. Prohibited Items: <br />3. Products: <br />Food List: <br />2050^^5 <br />5. Water Source: <br />*lf a private well, attach all updated water sample results (including quarterly bacteria and Nitrate results.) <br />6. Food Processor Course: <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420) F 209 464-0138 | www.sjcehd.com <br />5 <br />CFO Physical Address: <br />2690 Atherton Ct <br />CFO Business Name: <br />Pink Sparrow Bakery <br />Attach food handler certification for owner and each individual that were not submitted with initial application <br />(including family members and/or employees). <br />Initial if you agree to abide by the following: <br />Foods containing cream, custard, or meat fillings are potentially hazardous and are NOT ALLOWED. Only <br />foods that are defined as “non-potentially hazardous" are approved for preparation by a Cottage Food Operation. <br />These foods include items that do not require refrigeration to keep them safe from bacterial growth that could be a <br />cause of food-borne illness. <br />Please check what type of water source is being used at the CFO: <br />£3 City Water Private Well* <br />COTTAGE FOOD OPERATIONS (CFO) <br />REGISTRATION/PERMITTING RENEWAL FORM <br />CFO City: <br />Tracy <br />Date: <br />7/8/2025 <br />Website (If applicable): <br />N/A <br />Telephone: <br />209-221-5407 <br />Owner Name: <br />Tara Magnan <br />CFO Zip: <br />95304 <br />'p\2. <br />ooo \2Iq( <br />Environmental Health DepartmentSAN JOAQUIN <br />COU NTY <br />Provide a list of all products you are preparing. If preparing jams, jellies, or fruit butters include a list of <br />ingredients (attach separate page if needed). <br />Cupcakes, cakes, cookies, macarons, muffins, scones, quick breads, waffle <br />cones, dessert bars (rice cereal bars, brownies, biondies, etc.), fudge, marshmallows, <br />premade dry mixes (pancake mix, waffle mix, cookie mix, etc.), cinnamon rolls, <br />chocolate dipped nonperishable items (pretzels, marshmallows, etc.), fruit pies. <br />3 <br />4. Product Labelinq: O x \ <br />-------------------- ^o-l2-2^V Attach two labels to this form for two of your CFO products (only one label is required if only one product is <br />made). <br />1. Categories: <br />|%| “Class A” (Direct Sales Only) $186