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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). <br /> 7. Delivery Limitation: Initial if you agree to abide by the following: <br /> I understand that I may accept orders and payments via the internet, mail or phone. However, all"Class <br /> K 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 /> I, J' .Iwcr lasCai-ty 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 /> food-borne illness <br /> I, J_zZwe'— 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 /> ner's ignat re Print Name Date <br /> crFAMILY FARM <br /> os <br /> cano $NP — <br /> MADE INA WWOXICS3 <br /> SLEVIX LEAVES RRiX AT AVN FAN. No SILICON tga <br /> AR RNIXIUE ORDER FOB OXEI-COXING.JX DI IZ191 g <br /> E =a <br /> BBBG/!NIC BYCCBF 1 � A <br /> Joscano <br /> RO a a� <br /> RE DEM RLOOA HOME KITCHEN AT OUR FARM. quo <br /> NEINLCRALIMIT"OWN AT ANA-CAKI <br /> NO SIOCXX CI0gAE OZ 13 f0A ANTI-CAKING. E w a <br /> 125 0113501 <br /> CEXINIEA BAaux RX CCBF ,l Eds <br /> EHD 16-287/27/17 2 CFO REG/PERMITTING RENEWAL FORM <br />