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SAN JOAQUIN <br />---COU NT Y--- <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 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 />WI 'Dr._--/A ,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 I=1 "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 />1, ANusi-02 1 DFsoa , 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 />otherwise providing my CFO products to the consumer or retailers, regardless of whether the product is sold, <br />consigned, or given away. <br /> <br />AN Lis fp] TDFsnl I 0 <br />Print Name Date <br /> <br />Owner's Signature <br /> <br />2 of 2