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SANtt.J O A Q U I N Environmental Health Department
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<br /> COUNTY
<br /> 7. Delivery 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 " ss 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 /> 8. Owner's Statement:
<br /> I, �i,t�1 1,lCl�jhil 1�� 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 "Class B": For regular annual facility inspections
<br /> complaint or reported food-borne illness r and in the event of a consumer complaint or
<br /> food-borne illness
<br /> �uC(ShOI0< , 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 Print Name Date
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<br /> Made in a Home Kitchen Ju(i QuaSkniCk
<br /> Permit#:PT0025956-San Joaquin County (,209) 482-2923
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<br /> My Na w4Cookie* Made in a Hoene Kitchen
<br /> Permit
<br /> 151 MoiceUontl.RLvee Drive,Lod(.CA 9524 S
<br /> 0 :PTOCour tY
<br /> 1
<br /> Ingredients: Cookie-Flour(wheat flour,malted barley flour,niacin, 15Mokeluvv%ne River Drive
<br /> reduced iron,thiamine mononitrate,riboflavin,folic acid),butter, Lodi.CA asz4o
<br /> g eggs, Icing g ( ) Syrup ( Pecan Shortbread Cookie Ingnditactn,reduced
<br /> Flour
<br /> sugar,a S,vanilla.Ic -Powdered sugar COrn starch),COIR wheat flour,malted bade flour,n
<br /> iron,Calamine mononitrate,riboflavin,colic acid),
<br /> (Salt,vanilla extract),meringue powder(corn starch,egg whites, butter,sugar,pecans,vanilla
<br /> Contains: Wheat,nuts
<br /> sugar,gum arabic,sodium aluminum sulfate,citric acid,cream of (Made in a kitchen that uses nuts)
<br /> tartar,vanillin),water,cream of tartar,glycerin,vanilla extract. One Cookie
<br /> Contains: Eggs,Wheat One Cookie
<br /> 2 of 2
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