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SA N s)O A Q U I N Environmental Health Department <br /> COUNTY <br /> 7. Delivery Limitation: Initial if you agree to abide by the following: J <br /> I understand that I may accept orders and payments via the internet, mail or phone. However, all "Class A" and <br /> "Class B" CFO products must be delivered directly (in person) to the customer. The CFO products may not be <br /> delivered via the United States Postal Service, UPS, FedEx, or using any other indirect delivery method as <br /> deliveries are regulated by, and subject to, CDPH registration and state and federal requirements. <br /> 8. Owner's Statement: <br /> Ca?uk P-. A ru-,,4gree to grant access to the local health department to <br /> conduct an inspection of my cottage food operation (mark one) <br /> E�T"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, al J Qzo;d ��chdri� .Ykze,��' agree to notify the San Joaquin County Environmental <br /> Health Department prior to modifying my food list, type of operation, and/or method of selling, distributing, or <br /> otherwise providing my CFO products to the consumer or retailers, regardless of whether the product is sold, <br /> consigned, or given away. <br /> er�// ign ture / Print Name Da <br /> MADE IN A HOME KITCHEN <br /> Permit #PT0026155 <br /> Issued in county: <br /> San Joaquin <br /> Roasted Coffee <br /> Thirsty Bear <br /> Ingredients : Coffee <br /> 1424 W Locust St <br /> Lodi, CA 95242 <br /> 16 ounces (455 grams) <br />