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SA N-J O A Q U i N Environmental Health Department <br /> (-0U N T Y <br /> 7. Delive_ry_ 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 /> B. Owner's Statement: <br /> I, A n h c - E we(-,4A---- agree to grant access to the local health department to <br /> condu t an inspection of my cottage food operation (mark one) <br /> ❑ "Class A": In the event of a consumer ,Q�,"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 /> I, lqylocL6�IJa,ttoY , agree to notify the San Joaquin County Environmental <br /> Health epartment prior to modifying my food list, type of operation, and/or method of selling, distributing, or <br /> otherwise providiN my CFO pro cts to the consumer or retailers, regardless of whether the product is sold, <br /> nsigned, or ' en away- <br /> ,1 x -1 Al <br /> � r-,& 0C A S S <br /> wner's Signature Pr nt Name Date <br /> 1O/�l_7 m <br /> RCA o � E-2CLOD m > <br /> F,i '2 Q p �' M v; 0ai 4 <br /> PC <br /> J W U D it C` C O 6 C <br /> V m c c D u -- <br /> A <br /> /� r�. g 22 to C <br /> � pyA� �Lyp Ern ¢N <br /> EL <br /> V:7 m IF <br /> � sV O <br /> iR <br /> m <br /> 2of2 <br />