Laserfiche WebLink
SANJ O A Q U I N Environmental Health Department <br /> —COUNTY00' <br /> 9. Employee: 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: 00 <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 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 /> 11. Owner's Statement: <br /> Sam am boarp,i agree to grant access to the local health department to <br /> conduct an inspection of my cottage food operation(mark oneA ) <br /> Qy"Class A": In the event of a consumer "Class B": For regular annual facility <br /> / `complaint or reported food-bome illness inspections and in the event of a consumer <br /> complaint or food-bome <br /> I, d(GaA due Y1,g agree to notify the San Joaquin County <br /> Environmental Health Departirnent 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 product is sold, consigned, or given away. <br /> Sierras we Ke of i8 2021 <br /> Owner Sig ature Print Name Date <br /> 5 of <br /> ERU 1617 Wf 7 CFO REG/PERMfrfING FORM <br />