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6. Food Processor Course: <br />Attach food handler certification for owner and each individual that were not submitted with initial <br />application (including family members and/or employees). <br />7. Delivery Limitation: <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 <br />A" and "Class B" CFO products must be delivered direct) (in person) to the customer. The CFO products <br />may not be delivered via the United States Postal Service, UPS, FedEx, or using any other indirect <br />delivery method as deliveries are regulated by, and subject to, CDPH registration and state and federal <br />requirements. <br />8. Owner's Statement: <br />I, 64 ✓ IN M E CLIJES5 , 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 inspections <br />complaint or reported food -borne illness and in the event of a consumer complaint or <br />food -borne illness <br />I, ekl kG0 1 NC LLN -. S S , 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 />Signature <br />Print Name <br />to <br />?L) <br />EHD 16-29 1/6/14 2 CFO REG/PERMITTING RENEWAL FORM <br />