Laserfiche WebLink
SAN JOAQUIN <br /> <br />Environmental Health Department <br />--COUNTY-- <br />7. Owner's Statement: <br />, agree to grant access to the local health department to <br />conduct an inspection of my cottage food operation (mark one) <br />D "Class A": In the event of a consumer <br /> <br />tgi "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 />(...,A — I, --3-',A al— 0. - Va yl-'0 , 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 />Owner's Signature Print Name Name Date <br />END 16-29 6/27 /22 <br /> <br />2 CFO REG/PERMITTING RENEWAL FORM <br />Scanned with CamScanner