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wner's Signature <br />6. Food Processor Course: <br />Attach food handler certification for owner and each individual that were not submitted with initial <br />application (including family members and/or employees). <br />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 <br />A" and "Class B" CFO products must be delivered directly (in person) to the customer. The CFO products <br />may not be delivered via the United States Postal Service, UPS, FedEx, or using any other indirect <br />delivery method as deliveries are regulated by, and subject to, CDPH registration and state and federal <br />requirements. <br />Owner's Statement: <br />‘.4v-tis—AA.) , agree to grant access to the local health <br />depart nt to conduct an inspecti f my cottage food operation (mark one) <br />NE] "Class A": In the event of a consumer 111 "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 />, agree to notify the San Joaquin County <br />Envirofljbiental Health Departmen p or to modifying my food list, type of operation, and/or method <br />of selling, distributing, or otherwise pr iding my CFO products to the consumer or retailers, <br />regardless of whether the • oduct is sold, consigned, or given away. <br />-c4ritikiA.) tti tun <br />P_rf <br />Hi)-s-1 <br />rit Name ate <br />EHD 16-29 6/29/2015 2 CFO REG/PERMITTING RENEWAL FORM