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S f1 N J ., I O ANQ I IU I N Environmental Health Department <br />—ICV <br />COUNTY - <br />9. <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 />SA <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. Howeve r, 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 />11. Own <br />wn fli's Statement: � tmo�ft)Mry <br />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 E] "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 />I, 7agree to notify the San Joaquin County Environmental <br />Health Deparfment prior to modifying my food list, type of operation, and/or method of selling, distributing, or <br />otherwise providing m� CFO products to the consumer or retailers, regardless of whether the product is sold, <br />consigned, or given a ay. <br />WIM gray <br />Print <br />5of5 <br />