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N10 A Q U I N Environmental Health Department
<br /> .- OUNTY
<br /> 7. 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 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 /> 8. Owner's Statement:
<br /> I, Lrx#a tom. 1 O-bG � , agree to grant access to the local health department to
<br /> conduct an inspection of my bottage food operation (mark one)
<br /> ❑ "Class A": In the event of a consumer "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 Environmental
<br /> Health Department prior to modifying my fobd 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 /> unja D CPGIL 3) 1
<br /> Owner's nature Print Name I Date
<br /> MADE IN A HOME KITCHEN MADE IN A HOME KITCHEN
<br /> Permit#PT0025026 Permit#PT0025026
<br /> Issued in San Joaquin County Issued in San Joaquin County -
<br /> Linda Raby Linda Raby
<br /> 1835 Piedmont Drive 1835 Piedmont Drive
<br /> Manteca, CA 95336 Manteca, CA 95336
<br /> (805)550-9542 (805) 550-9542
<br /> RASPBERRY MUFFIN SUGAR COOKIE
<br /> Ingredients: Enriched flour(bleached wheat Ingredients: Enriched flour(bleached wheat flour, malted
<br /> flour,malted barley flour, niacin,iron,thiamin mononitrate, barley flour, niacin,iron,thiamin mononitrate, riboflavin,
<br /> riboflavin,folic acid), raspberries,sugar,milk(nonfat milk, folic acid),sugar, butter(milk,salt),eggs, baking powder,
<br /> vitamin A palmitate,vitamin D3),vegetable oil,egg, baking milk(nonfat milk,vitamin A palmitate,vitamin D3),vanilla,
<br /> powder, vanilla,salt. salt.
<br /> Topping:Sugar,enriched flour(bleached wheat flour,
<br /> malted barley flour,niacin, iron,thiamin mononitrate, CONTAINS: WHEAT,EGGS,MILK
<br /> riboflavin, folic acid, butter(milk,salt),cinnamon.
<br /> Net Wt. oz( g)
<br /> CONTAINS: MILK,EGGS
<br /> Net Wt. oz( g)
<br /> of 2
<br />
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