Laserfiche WebLink
Owner's Signature <br />---.....mke,121026FAissmitaminagr.- <br />SAN JOAQUIN <br />- • <br />EnvIrumnontal I lealth Dopartmomt <br />Delivery Limitation: Initial if you agree to abide by the following: <br />I understand that I may accept orders and payments via the intemet, 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, 0._,K\i" Cc% \-D‘ bit1r. ,agree to grant access to the local health department to <br />conduct an inspection of my cottage food operation (mark one) <br />111 "Class A": In the event of a consumer <br />complaint or reported food-borne illness <br />[01"Class B": For regular annual facility inspections <br />and in the event of a consumer complaint or <br />food-borne illness <br />I, , agree to notify the San Joaquin County Environmental <br />Health Department prior to modifying my rood list, type of operation, and/or method of selling, distributing, or <br />otherv,ise providing my CFO products to the consumer or retailers, regardless of whether the product is sold, <br />consigned, or given away. <br />Obk leLoa-kl b‘6,after n, <br />Print Name <br />2 of 2