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SA AI J O A Q U I N Environmental Health Department <br />—COUNTY - <br />9. Employee: Initial if you agree to abide by the following: <br />I 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 />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. However, all "Class A" and <br />"Class B" CFO products must be delivered direct) (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. Owner's Statement: <br />I, Stn& A- C i /1 Ai9,0 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 -borne illness inspections and in the event of a consumer <br />complaint or food -borne <br />I, A7iC1W 14 ( 1 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 />sn>I>Le�t �r�w�zd 3 q W <br />Owner's Signature Print Name Date <br />5 of <br />