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S►{ NJ O A a U I Environmental Health Uopa1tillu <br />COUNTY - <br />9. Employee: Emalovee: Initlai if you aeras 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 1 may accept orders and payments via the Internet, mail or phone. However, at '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 />11. Owner's Statement: <br />1, f'al t Itt kI (jhft'�4. agree to grant access to the local health department to <br />conduct arf Inspection of my cottage food operation (mark one) <br />"Class A": In the event of a consumer <br />complaint or reported foodborne illness <br />❑ "Class B": For regular annual facility <br />Inspections and in the event of a consumer <br />complaint or food-bome <br />I, Yol I l o\ agree to notify the San Joaquin County <br />Environiental 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 />5of5 <br />EHD 18.27 WPM CFO REO/PERMrMNG FORM <br />