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8 Food Processor Course: <br />For more information see CDPH website www.cdph.ca.qov/proqrams/Paqes/fdbCottaqeFood.aspx <br />9. Employee: <br />10, Delivery Limitation: <br />11. Owner’s Statement: <br />5 CFO REG/PERMITTING FORMEHD 16-27 6/29/2023 <br />Initial if you agree to abide by the following:AP <br />Within 3 months of being approved to operate by the Environmental Health Department, please <br />provide proof of completion of the California Food Handler course in lieu of the California Department <br />of Public Health (CDPH) food processor course. <br />Initial if you agree to abide by the following:AP <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 sale to <br />consumers. <br />Initial if you agree to abide by the following:AP <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 />I,Adhithi Prabhuraj , agree to notify the San Joaquin County Environmental Health <br />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 <br />is sold, consigned, or given away. <br />0 “Class A”: In the event of a consumer <br />complaint or reported food-borne illness <br /> “Class B”: For regular annual facility <br />inspections and in the event of a consumer <br />complaint or food-borne <br />Adhithi Prabhuraj <br />Owner’s Signature <br />ADHITHI PRABHURAJ <br />Print Name <br />I,Adhithi Prabhuraj, agree to grant access to the local health department to conduct an <br />inspection of my cottage food operation (mark one) <br />1/15/2025 <br />Date