Laserfiche WebLink
SAN. J O A Q U I N Environmental Health Department <br /> COUNTY- <br /> 7. Delivery Limitation: Initial if you agree to abide by the following: Ld& <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 /> Pleas.? Syn attched hB 044 FarfSln2¢�fi 5jattn d�veG( d�u <br /> 8. Owner's Statement: i y\eltYe ui 5a(,aS ry)&Aj be"Ulfi'.l� i h rSN,, V I� m�i (l�'I <br /> oY u,Sin�( +,kir4. (5'+- d? Ilo.Piry �ivviU -M— <br /> I 14- Sia le-OW J , 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-bome illness and in the event of a consumer complaint or <br /> food-borne illness <br /> I, I-<r i s'Fa V-6H t 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 /> Q {� KOKI, zg/zz <br /> vOw ie s Sgnature Print Name Date <br /> EHD 16-29 6/27/22 2 CFO REG/PERMITTING RENEWAL FORM <br />