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❑ Nitrite Test(every 3 years'): <br /> —Additional information may be required if food is prepared from a home with a private water supply—check with local jurisdiction_ <br /> 8. Food Processor Course: Initial if you agree to abide by the following: RB <br /> Within 3 months of being approved to operate by the Environmental Health Department, please <br /> provide proof of completion of the California Food Handier course in lieu of the California Department <br /> of Public Health (CDPH) food processor course. <br /> For more information see COPH website www.cdph.ca.gov/prografts/Pages/fdbCottageFood.aspx <br /> 9. Employee: Initial if you agree to abide by the following: RB <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 saie to <br /> consumers. <br /> 10.Delivery Limitation: Initial if you agree to abide by the following: RB <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, Rasha Bar Barmada 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-borne illness inspections and in the event of a consumer <br /> complaint or food-borne <br /> I, Rnsha Rarmada 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 or retailers, <br /> regardless of whether the product is sold, consigned, or given away. <br /> Rasha Barmada 20/1/2024 <br /> Owner's Signature Print Name Date <br /> RH©16-27 6/2912023 5 CFO RECdPRRMITTING FORM <br />