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SA 6J O A Q U I N Environmental Health Department <br /> —COUNTY- <br /> 9. Employee: Initial if you agree to abide by the following: <br /> I understand that I may not have more than one full-time equivalent cottage food employee,not including 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 stale and federal requirements. <br /> 11. Owner's Statement: <br /> I,_ \ r-ry N�M r� agree to grant access to the local health department to <br /> conduct an inspection of my cottage food operation(mark one) <br /> 1?1"Class A": In the event of a consumer ❑ "Class B": For regular annual facility <br /> complaint or reported food-bome illness inspections and in the event of a consumer <br /> complaint or food-bome <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 the product is sold,consigned,or given away. \\ <br /> �_ \ rZ f�L�9�Y.Rt,,,_ <br /> Owners signature int Name Date <br /> Sots <br /> EHD 1637 689/17 CFO REWERMrMNG FORM <br />