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SAN JOAQUIN <br /> <br />Environmental Health Department <br />COUNTY <br />7. Owner's Statement: <br />• <br />I [-"ra C9Xf°'°1 , agree to grant access to the local health department to <br />conduct an inspection of my cottage food operation (mark one) <br />"Class A": In the event of a consumer <br />complaint or reported food-borne illness <br />"Class B": For regular annual facility inspections <br />and in the event of a consumer complaint or <br />food-borne illness <br /> <br />, 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 />othe roviding my CFO products to the consumer or retailers, regardless of whether the product is sold, <br />away. <br />LAAArA &otroi/i <br />Print Name <br />221r2 <br />Date <br />END 16-29 6/27/22 2 CFO REG/PERMITTING RENEWAL FORM