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SA N sJ O A Q U I N Environmental Health Department
<br /> —COUNTY-
<br /> 7. Delivery Limitation: Initial if you agree to abide by the following: 5
<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, C QOY cafe Q , agree to grant access to the local health department to
<br /> conduct an rdspection of my cottage tbod 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 /> ��^ 4Q� food-borne illness
<br /> I, br43yN_k sJ Y✓)Gk tM I�qU agree to notify the San Joaquin County Environmental
<br /> He..It��h Dep ment prior to modifyi g 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 /> Z,6
<br /> wner's Signature Print A14he Date
<br /> p an TnCmkirc(,S w.;14 g) _
<br /> dealnOmv�Q ro oriel,m lcmia.wiil.�om4�+.�n n0-ww. W In n ac l
<br /> Bmwni30 or,85 g)
<br /> pmav,TWW lhvm(wsm,abrain myek weilh bora eaharWerx wh hWedieft dark Soni sweet chocolate (unsweetened chocolate, m
<br /> Made in a Home Kitchen. (emulsifier).wtural vanilla salon,m �`• wm mge, ag wy lecithin
<br /> remaa-,orator T.an IMT•+sra ""? panrr z ) �r•eg&bmter(mila,all),walmns,beauty sugar(sugar.invert
<br /> -Contains wheal,milk,and nuts. waar• rare mol's�)• enriched nom (wheal lleur, niae� reduced ima, thinuume, motronitmre,
<br /> nboflavin,folic acid),cocoa powder(pmcerad with annail,il,sweelentd mMensed milk(milk ma.),
<br /> tom syrup(lite coo syrup,mlk --ilia), soh, belting powder(baking coda, rum c ml, sodium
<br /> aluminum miphale,calcium mlphak,mvncealchvn phospLam),baking soda,vanilla flavor(water.
<br /> glycerin,Organic vanilla bean eatractives)
<br /> Made in a Home Kitchen
<br /> 1'e1nit 8 MM5769 Teepee Cake, 1742 Trs La.Manteca,Ca 933)7 (209)740-2$32
<br /> •Contains wheat,milk eggs,soy,tree nuts.
<br /> 2 of
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