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CI I V II V I III ICI IIOI fIC41U l UCrldl LMC 111 <br /> JAN JUAVUIN <br /> <_ ouNj_v <br /> 7. Delivery Limitation Initial if you agree to abide by the following: KS <br /> I understand that I may accept orders anda ents via the internet, mail or phone. However, all"Class A" and <br /> Products must be delivered <br /> "Class B" CFO directly retly(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, .KE"-y J N>E agree to grant access to the local health department to <br /> conduct an inspection of my cottage food operation (mark one) <br /> ❑ "Class A": In the event of a consumer Lt 11Class B": For regular annual facility inspections <br /> complaint or reported food-borne illness and in the event of a consumer complaint or <br /> 1/ 1s�� food-bome illness <br /> I, VE-R�y 5�u i ) 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 /> ay- <br /> . SI1�D k�+ 2.z <br /> Ow is Signature Print Name Datel <br /> EHD 1&2962722 2 CFO REGIPERMITnNG RENEWAL FORM <br />