|
S n K O A Q I u I IN
<br /> Environmental Health Department
<br /> —+--�-C OUNTY
<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, 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 /> �I w
<br /> , agree to grant access to the local health department to
<br /> conduct an inspection of my cottage food operation (mark one)
<br /> E] "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, dor. �raGt n i x" agree to notify the San Joaquin County Environmental
<br /> Health D artment 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 /> f ` A �C-�t 1 2C "n11 l
<br /> wneA Signature Tint Name Date
<br /> Blackhenv Crogada(5.9 oz. 167,w1
<br /> 11010mdientir.blackberries,enriched Flour(wheat flour,niacin,reduced iron. Rac y Muffin((OZ; 170 g)
<br /> thiamine, mononitrate, riboflavin, folic acid), butter(milk, salt), sugar,
<br /> almond egg,water,salt. > -6 1,M now(Wb..r hour,.i..io.,�o.od arm, m000.iu.�c.�d�,n..�.
<br /> flAw.;d)...a.r,nqA ny,mak.,,,w�,�,(.0—d Pa.�..�,._a.r,�.,,,•�rnu..1.b.-
<br /> Made in a Home Kitchen (.r..m,..,w.t n.rwioa.)..asa,br,,.m..a.,i>uH.r.� rr A, „� m d.. .t.n.kioa
<br /> Permit ft PT0025769 Teetarts Cakes P—de,(h-b.9.d.,.oro.�,r.h...Ji—.1.r,i ,�.uirh_..,)....iph-,
<br /> Ph-Th.r.).. 96 n....(..�..ety..riu.waw,�...odi.b,xu.xo-..u�..).b.ki.s.,.t.. Jt
<br /> 1742 Tasca Ln.Manteca,Ca 95337 (209)7a0-zss2 Made in a Home Kitchen.
<br /> •Contains wheat,milk,nuts,and eggs. PerwitfFM25769 TmlarrsCake. i742T. L..twnux.,C.95an a09)7eo 832
<br /> 'Contains wheat,milk,eggs.
<br /> 2 of 2
<br />
|