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I Mwnlfh fi^p}rtrr>or>* <br />8 Owner’s Statement: <br />f <br />2 of 2 <br />□ "Class B”: For regular annual facility inspections <br />and in the event of a consumer complaint or <br />food-borne illness <br />^5 'Class A : In the event of a consumer <br />complaint or reported food-borne illness <br />SAN JOAQUIN <br />COUNTY <br />DateOwner's Signature <br />Y Limitation Initial If you agree to abide by the following <br />I understand that I may ar'cerf orders and payments vsa the internet mail or pbon« However all Cass A ^r-n <br />< i.-»*s P ( 1 C products must be de’ ve'ed directly |m person) to (’’*» customer The CFO products may not r>* <br />dein-rreo via me United States Postal Service UPS FedEx or using any other indirect delivery method a<; <br />dei-s-e-ies are regulated b> and subject to CDPH req-strafion and state and federal requirements <br />1 -------r- . agree to grant access to the local health department to <br />conduct an inspection of my cottage food operation (mark one) <br />I x - C laia-z pyxY f , 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 />Print Name