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SANJ O A Q U I N Environmental Health Department <br /> C0U_ 1 -V <br /> 9. Employee: Initial if you agree to abide by the following: L 11 <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. Owner's Statement: <br /> ^1 <br /> I, LU S M U 1 Irl , agree to grant access to the local health department to <br /> conduct an inspection of my cottage food operation (mark one) <br /> O'Class A": In the event of a consumer ❑ "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 /> II A'o <br /> (_,l 5 MR, 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 /> ��_5 #Zft <br /> Owner's Signature Print Name Date <br /> 5of5 <br />