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SANJOAQUIN <br />Environmental Health Department <br />—COUNTY-- <br />Delivery Limitation: <br />Initial if you agree to abide by the following: C. <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 directly (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 />Owner's Statement: <br />I, agree to grant access to the local health department to <br />conduct an inspe tion of my tottage food operation (mark one) <br />"Class A": In the event of a consumer "Class B": For regular annual facility inspections <br />omplaint or reported food-borne illness and in the event of a consumer complaint or <br />food-borne illness <br />I, <br />/"11.Q <br />..5s-in--,,, agree to notify the San Joaquin County Environmental <br />Health Departm nt prior to m idifying my food list, type of operation, and/or method of selling, distributing, or <br />otherwise providing my CFO p oducts to the consumer or retailers, regardless of whether the product is sold, <br />consigned, or given away. <br /> <br />kivrC 1‘ `;4ivi ( I g <br />Print Name Date <br /> <br />-- Owner Signature <br /> <br />2 of 2