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SA N g10 A Q U I N Environmental Health Department
<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, "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 /> 8. Owner's Statement
<br /> i9Skl' \ gu�A
<br /> % DOd -, agree to grant access to the local health department to
<br /> conduct aft-inspection of my 66ttage food operation (mark one)
<br /> Class A": In the event of a consumer El "Class B": For regular annual facility inspections
<br /> omplaint or reported food-borne illness and in the event of a consumer complaint or
<br /> food-borne illness
<br /> I, � P.0 /IA• YNAAA�1 n 0k 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 /> const ed, or given away.
<br /> LAnNA - Yaujwkadlt 3_�
<br /> Owlh Sigriat r Print Name Date
<br /> MADE IN A HOME KITCHEN
<br /> Permit#:PT0026826 J • .
<br /> Issued In County:San Joaquin
<br /> Sugar Cookie
<br /> The Wooden Spoon Baked Goods '
<br /> 245 Douma Way .
<br /> Ripon,CA 95366
<br /> (209)923-0599
<br /> Ingredients:Fkas:(Unbleached Vd,eal Fkna,Maned Barley Flour,Merin.trop,Thiamin.Marr trata,
<br /> Rib Bain.Falk Arid),Sugar.Baler(Milk,Sett),Eggs,V la ExbaU.Baking Powder.Meringue Powdar,
<br /> mer - —
<br /> con, ,Addrlel Color --. -
<br /> conta ns:W mid,Milk,Eggs
<br /> Net WL 1.8 oz(51.029 g)
<br /> MADE IN A HOME KITCHEN
<br /> Permit#:PT0026826
<br /> Issued In County:San Joaquin
<br /> Zucchini Bread
<br /> The Wooden Spoon Baked Goods
<br /> 245 Douma Way
<br /> Ripon,CA 95366
<br /> 1 (209)923-0599
<br /> Ingredients:Flour:(Unbleached Wheat Flour,Malted Barley Flour,Niacin,Iron,Thiamin,
<br /> Mononhrate,Riboflavin,Folic Acid),Sugar,Zucchini,Oil,Eggs,Cinnamon,Baking
<br /> Powder,Baking Soda,Salt,Vanilla Extract
<br /> Contains:Wheat,Eggs Cinnamon
<br /> Net WL 3.Ooz(85.048g)
<br /> 2 oft
<br />
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