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6. Food Processor Course: <br /> Attach food handler certification for owner and each individual that were not submitted with initial <br /> application (including family members and/or employees). /1 <br /> 7. Delivery Limitation: Initial if you agree to abide by the following: �tX <br /> 1 understand that I may accept orders and payments via the internet, mail or phone. However, all"Class <br /> A"and "Class B" CFO products must be delivered directly(in person) to the customer. The CFO products <br /> may not be delivered via the United States Postal Service, UPS, FedEx, or using any other indirect <br /> delivery method as deliveries are regulated by, and subject to, CDPH registration and state and federal <br /> requirements. <br /> 8. Owner's Statement: <br /> 1, L U t n,4i_ck N QU ti qp(N agree to grant access to the local health <br /> department to conduct an inspection of my cottage food operation (mark one) <br /> ❑ "Class A": In the event of a consumer "Class B": For regular annual facility inspections <br /> complaint or reported food-borne illness and in the event of a consumer complaint or <br /> p� <br /> food-borne illness <br /> I, r]e C\4 ck A QU f b'A 0( agree to notify the San Joaquin County <br /> Environmental Health Department prior to modifying my food list, type of operation, and/or method <br /> of selling, distributing, or otherwise providing my CFO products to the consumer or retailers, <br /> regardless of whether the product is sold, consigned, or given away. <br /> Owner's Signature Print Name Date <br /> EHD 16-297/27/17 2 CFO REG/PERMITTING RENEWAL FORM <br />