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SANJ O A O U I N Environmental Health Department <br />—COUNTY- <br />7. Delivery Limitation: Initial if you agree to abide by the following: f_ <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 />1, �Zj C it:�F0 , 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 ❑ "Class B": For regular annual facility inspections <br />complaint or reported food -borne illness and in the event of a consumer complaint or <br />food -borne illness <br />I, C94 & f U , 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 />IN SEMO)r <br />Plum ,dam <br />j Ingredients: sugar, Hums. Lemon im, <br />8 OZ. rV <br />Q 48068. oaquin J <br />Sun r&moatu0Conn, <br />County (� <br />eennnx PN0253I14 <br />eh—(c FIF,'o <br />Print Name <br />IN <br />Straw6erg <br />$ OZ. ,lam <br />'31r�gredienfs: Sugar, Strawbem Lemon Juice <br />�O <br />4806 E. Fourth St Stockton, CA 95215 .� <br />f� Pen Joaquin <br />rmlt# mooCounty3 <br />`q 110mt � <br />-- //- z'Z- <br />EHD 16-29 6/27/22 2 CFO REG/PERMITTING RENEWAL FORM <br />