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• SAN J0AQUIN <br />—COUNTY- <br />7. Delivery, Limitation: <br />Environmental Health Department <br />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 state and federal requirements. <br />8. Owner's Statement: <br />( t OU L �%FI agree to grant access to the local health department to <br />conduct an inspection of my cottage food operation (mark one) <br />'MIClass A": In the event of a consumer <br />complaint or reported food -borne illness <br />❑ "Class Bit: For regular annual facility inspections <br />and in the event of a consumer complaint or <br />food -borne illness <br />It < 3quL A' / , agree to notify the San Joaquin County Environmental <br />Health Department prior to modifying 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 />MADE IN A HOME KITCHEN <br />Permitil PT0025201 <br />Issued in San Joaquin County <br />Fondant <br />Tres Sweets <br />2981 Balboa Or. <br />Tracy Ca 95378 <br />Sugar. Whaal Symp, palm <br />OII, Water, Glymrin. Gum TraBawnlh, Tapioca Susan, Sodium <br />Ce�bovmNM1yI Dellulosa, Nawral and Ani Idol Flavor, TIIanWm Dbdide IDolorl. sodium Aceum. <br />Aceto ACid. <br />Madam a F¢Ilhy that Also Procan.. Tree Nuts, E99. MIIN and Say Pmducui IA\V1 <br />V \ <br />I/qVZ 6 /,� 51,P/aa- <br />Print Name <br />2 of 2 <br />MADE IN A HOME KITCHEN <br />Permit # PT0025201 <br />Issued in San Joaquin County <br />Edible Adhesive <br />T.. Sweats <br />2981 Balboa D,. <br />Tracy Ca 95376 <br />Water. Tapiot¢ Deacon. pek,mae Clark, Aad, xand en (PreseGum Prapvlene cirwl. sndmm <br />eenzoala rvaliva). AM it Fl <br />Itl acon. <br />"i <br />