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SAN JOAQUIN <br />c-OUNTY <br /> <br />Environmental Health Department <br />Delivery Limitation: Initial if you agree to abide by the following: — <br /> <br />I understand that I may accept orders and payments via the intemet, mail or phone. However, all 'Class K 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, A t-.2eJ I-•4% (:),e__ cr CLk rn <br />, agree to grant access to the local health department to <br />conduct an inspection of y cottage food operation (mark one) <br />\Ig 'Class A": In the event of a consumer 0 "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 />C -2 , agree to notify the San Joaquin County Environmental <br />Health Department <br />prior to modifying my food list, type of operation, andlor 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 />IL <br />Owner's Signature <br />MADE IN A HOME KITCHEN <br />PERMIT - PT0026247 <br />SWETHA'S KITCHEN <br />511 W. TRAMONTO DR. <br />TRACY, CA 95391 <br />NET WT. OZ <br />MADE IN A HOME KITCHEN <br />PERMIT - PT0026247 <br />SWETHA'S KITCHEN <br />511 W. TRAMONTO DR. <br />TRACY, CA 95391 <br />NET VVT. OZ <br />yJasm 2_(--• 40 . -2_0 23 <br />Date <br />Print Name