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❑ Nitrite Test(every 3 years'): <br /> "Additional,ninrmallon may be required if food is prapared from a homrx with a pale waler supply—check Mlh local Jurisdiction <br /> 8. Food Processor Course: Initial if you agree to abide by the following: <br /> Within 3 months of being approved to operate by the Environmental Health Department, please <br /> Provide proof of completion of the California Food Handler course in lieu of the California Department <br /> of Public Health (CDPH)food processor course. <br /> For more mformauon see CDPH websile www cdph-ca-ciovlprcgramsfPageslfdbco"aGeFood aspx <br /> 9. Employee: Initial if you agree to abide by the following: V� <br /> I understand that I may not have more than one full-time equivalent cottage food employee, not <br /> including a family member or household member of the cottage food operator, working within the <br /> registered or permitted area of a private home where the cottage food operator resides and where <br /> cottage food products are prepared or packaged for direct, indirect, or direct and indirect sale to <br /> consumers. <br /> 10.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. Direct and <br /> Indirect sales may be fulfilled in person, via mail delivery, or using any other third-party delivery <br /> service throughout the state of California only. <br /> 11. Owner's Statement: <br /> I. V I S�T RL T. RDMA I n E agree to grant access to the local health <br /> department to conduct an inspection of my cottage food operation (mark one) <br /> "Class A": In the event of a consumer ❑ "Class B": For regular annual facility <br /> complaint or reported food-bome illness inspections and in the event of a consumer <br /> �� �� '� complaint or food-borne <br /> I' T� _0M� �Al , agree to notify the San Joaquin County <br /> Environmental Health Department prior to modifying my food list, type of operation, and/or method <br /> of selling, distributing, or otherwise providing my CFO products to the consumer ar retailers, <br /> regardless of a the product is sold, consigned, or given away, <br /> Owners Signature Name �6 08 <br /> Print -o9 ZOZ� <br /> Date <br /> fHG 1&278 M2()23 <br /> 5 <br />