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Environmental Health Department <br />8. Owner’s Statement: <br />l, <br />2 0t2 <br />xT“Class A”: In the event of a consumer <br />comolaint 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 />SAN JOAQUIN <br />-COUNTY <br />Date <br />_______________. agree to notify the San Joaquin County Environmental <br />idifying 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 />I, c k J , agree to grant access to the local health deoartment to <br />conduct an inspection of myCcottage food operation (mark one) <br />. Delivery Limitation: Initial if you agree to abide by the following: —L_2_— <br />understand that I mav 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 prooucrs may not mc <br />delivered via the United States Postal Service, UPS, FedEx, or using any other indirect deliverv method as <br />deliveries are regulated by. and subject to, CDPH registration and state and federal requirements <br />Print Name <br />/VtU2! ylc <br />Health Department prior to rnoi <br />:FOtr< <br />consigned, or given away. <br />Owner's Signature