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SA N J O n n U I N Environmental Health Department <br /> /iCOU FNIT�JY- '`I <br /> 9. Employee: Initial if you agree to abide by the following: <br /> understand that I may not have more than one full-time equivalent cottage food employee,not includkg a <br /> family member or household member of the cottage food operator,working within the registered or permitted <br /> area of a private home where the cottage food operator resides and where cottage food products are prepared <br /> or packaged for direct,indirect,or direct and indirect sale to consumers. <br /> 10. 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 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 /> 11. Owner's Statement: <br /> I, jk rl�41 Kit J U,K agree to grant access to the local health department to <br /> 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 <br /> complaint or reported food-borne illness inspections and in the event of a consumer <br /> complaint or food-borne <br /> agree to notify the San Joaquin County <br /> Environmental Health Department prior to modifying my food list,type of operation,and/or method of <br /> selling,distributing,or otherwise providing my CFO products to the consumer or retailers,regardless of <br /> whether product is sold,consigned,or given away. <br /> Owner's Signature Print Name Date G'1y '�� 1��C1 <br /> 5of5 <br /> EHD 16-27 6/29/17 CFO REG/PERMITTING FORM <br />