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Environmental Health Department <br />7. Delivery Limitation: <br />8. Owner’s Statement: <br />l. <br />! <br />2of2 <br /> <br />Created with Scanner Pro <br />ci—i <br />Made in a home kitchen <br />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 />□ “Class B”: For regular annual facility inspections <br />and in the event of a consumer complaint or <br />food-bome illness <br />TMcxCAtSVZ <br />Cm—* Omb O*—■« «|W ■) <br />Ci— MMM MM tM MM «M«M BM MMM. <br />MMM « —« MM <M <MM KHMII MOM M M> *«■ <br />Contain*: wtwat. agg*. milk <br />Made in a home kitchen <br />SANJOAQUIN <br />-----COUNTY <br />Date <br /> ., 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 />Owner's Signature b Print Name <br />i. AhnsfwiTbZ , 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 <br />r complaint or reported food-bome illness <br />Tlna'tTrwta <br />Tracy, CA 95377 <br />P*ml« PR25002S6 lUMd in San Joaquin County <br />C— Battar Cupcaka - 3 oi (U g) <br />Igrariai bn— — tour t— ku naon MuoM ton <br />— woMranM. kk mi bow (ink Mi). UMm*. <br />«w a— «W>. wg—> ok augar. Mag pomi. ma. pua nNta