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1.7-Nov-2020 16:26 Private And Confidential. From:2093679996 P.7 <br /> ry I f`l A E j Environmentaf Health Department <br /> 'SAN <br /> _.._...Col.J1VTy___-.. n r, <br /> 9. EmploVee: Initial if you agree to abide by the following: <br /> I understand that I may not have more than one full-time equivalent cottage food employee, not including a <br /> family member or household member of the cottage food operator,working within the registered or permitted <br /> area of a private home where the cottage food operator resides and where cottage food products are prepared <br /> or packaged for direct,indirect,or direct and Indirect sale to consumers. <br /> 10. Delivery Limitation: Initial if you agree to abide by the following: v P` <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 directiv(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 stale and federal requirements. <br /> 11. Owner's Statement: <br /> { C . /" <br /> I, 'Dwa! t•:i" E i"' Z 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 <br /> complaint or reported food-borne illness Inspections and in the event of a consumer <br /> complaint or food-borne <br /> 1, t 3 tf ,SON���1 agree to notify the San Joaquin County <br /> Environmental ealth Department prior to modifying my food list,type of operation, and/or method of <br /> selling,distributing,or otherwise providing my CFO products to the consumer or retailers, regardless of <br /> whether the roduct is sold, consigned,or given away. <br /> a- <br /> ^ ✓I it -e . •2 9--. <br /> OYVnerS Signature Print Mame Date <br /> G ofS <br /> EHD 16-27 6/29/17 CFO REGMERMITTING FORM <br /> Received Time Nov. 17• 2020 3 : 19PM No, 6468 <br />