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Environmental Health Department <br /> SAN OWN <br /> --COU NTY <br /> Initial if you agree to abide by <br /> the following: <br /> g. Emp_ low- e food employee, not including a <br /> not have more than one full-time equivalent cottag within the registered or permitted <br /> I understand that I may <br /> family member or household member offoodfood the toperatoordresides tand where cottage food products are prepared <br /> area of a private home where the cottage <br /> or packaged for direct, indirect, or direct and indirect sale to consumers. <br /> and <br /> 10. Delivery Limitation: Initial if you agree to abide by the following: <br /> — <br /> I understand that I may accept orders and payments via the internet, mail or phone. However,ducl" may not be <br /> ass N' <br /> "Class B" CFO products must be deli ered I Service, UIPS!nFedEx, or using any other indirect delivery method as <br /> delivered via the United States Posta <br /> deliveries are regulated by, and subject to, CDPH registration and state and federal requirements. <br /> 11. Owner's Statement: <br /> 16 agree to grant access to the local health department to <br /> conduct an inspe i n of my cottage food operation (mark one) <br /> ❑ "Class A": In the event of a consumer `T"Class B": For regular annual facility <br /> complaint or reported food-borne illness inspections and in tie event of a consumer <br /> complaint or food-bane <br /> agree to notify the San Joaquin County <br /> EnvironmeriWI 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 the product is sold, consigned, or given away. <br /> 0 <br /> l o��YL p <br /> Ovifheris Signature Print Natne Date <br /> EHD 16-27 6/29/17 5 of 5 <br /> CFO REG/PERMITTING FORM <br />