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SAN JOAQUIN <br />- COUNTY-- <br />Environmental Health Department <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 />R"Class A": In the event of a consumer <br />complaint or reported food-borne illness <br />O "Class B": For regular annual facility inspections <br />and in the event of a consumer complaint or <br />food-borne illness <br />WitL v Ion riA.t-ctl-k , agree to notify the San Joaquin County Environmental 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 />1410tt. V - kn'llinkrALA <br />Print Name <br />11- 12 - "2-3 <br />Owner's Signature Date <br />1, WKL V - 1\-atartk -v-p <br />2 CFO REG/PERMITTNG RENEWAL FORM END 16-296127/22