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SA N X10 A Q U IN Environmental Health Department <br /> CC)0NTY <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 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, FedE-x, 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 /> I, n t�� W I , 1-S 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 inspections <br /> complaint or reported food-borne illness and in the event of a consumer complaint or <br /> food-borne illness <br /> I, 1„(inW{ `t r'-� 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 /> I,ul� G — C')1{! <br /> , lz�� Rldi2_Owner's Signature Print Name Date <br /> Ingredients Flour(unbleached hard red wheat <br /> and malted barley)granulated sugar,brown <br /> sugar,butter,eggs,vanilla,baking soda,salt <br /> T r D U G r while-chocolate chips <br /> OO M S Contains:eggs,dairy,wheat,may contain <br /> Cookies traces of nuts. <br /> 1 COOK)* <br /> Ingredients: Flour(unbleached hard red wheat <br /> and malted barley)granulated sugar,brown <br /> (209) 294-1874 sugar,butter,eggs,vanilla,baiting soda,salt, <br /> 1870 Dove Court,Lodi CA 95240 milk-chocolate chips. <br /> Contains:eggs,dairy,wheat,may contain <br /> Made in a Home Kitchen traces of nuts <br /> PermO PT 0028248 1.r,ae nCo,nry San kapWn <br /> 2 of 2 <br />