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SAN10 A Q U I N Environmental Health Department <br /> COUNTY �j <br /> 9. Employee: Initial if you agree to abide by the following: �`+ <br /> 1 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 tin Dersonl 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 /> I. �2 �DO. agree to grant access to the local health department to <br /> conduct Th inspection of my cottage food operation(mark one) <br /> ❑"Class A": In the event of a consumer "Class B": For regular annual facility <br /> complaint or reported food-borne illness inspections and in the event of a consumer <br /> complaint or food-bome <br /> I, Rem \apaw agree to notify the San Joaquin County <br /> EnvironnWntal 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 /> Q.L e a Id q-2 <br /> is Signature Print Name Date <br /> 5 of <br /> FHl 16-97 A00117 rcn ocrr"oonurri".r...r.. <br />