Laserfiche WebLink
SANJ O A Q U I N Environmental Health Department <br /> COUNTY -- <br /> 9. Employee: Initial if you agree to abide by the following: i'VV-A) <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 /> 1 <br /> 10. Delivery Limitation: Initial if you agree to abide by the following: MAJ <br /> I understand that I may accept orders and payments via the internet, mail or phone. However, all "Class K 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's1 ' Statement: �(� <br /> I, ty1U rt L y�M 't�� <br /> ,agree to grant access to the local health department to <br /> conduct an inspection of my c6ftage 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-bome <br /> agree to notify the San Joaquin County <br /> Environmental Health-Departenent prior to modifying my food list,type of operation, and/or method of <br /> selling, distplacting, othe ise providing my 0 products to the consumer or retailers, regardless of <br /> whether a prod is sold, onsigned, or g' n away. <br /> rA4JL&4 W 0A kXV 415 2 <br /> w is Signa" re Print Name Date <br /> 5of5 <br /> EHD 16-276/29117 CFO REG/PERMITTING FORM <br />