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SA N J O A Q U I N Environmental Health Department <br />C-C)t! N T Y <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: <br />Initial if you agree to abide by the following: WA' <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 />I, co\� 1:;0-t 4` f` r"�I , agree to grant access to the local health department to <br />conduct an inspection of my cottage foo operation (mark one) <br />Q "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 -tome <br />I, Ccs\Ifrh agree to notify the San Joaquin County <br />Environmental Health Department prioko modifying my food list, type of operation, and/or method of <br />selling, distri ing,or otherwise providing my CFO products to the consumer or retailers, regardless of <br />whe r pr uct i nsigned, or given away. <br />I I A-'lp,2- 1 <br />Owne Signat Print Name Date <br />5 of <br />EHD 1627 8/29/17 CFO REG/PERMfrTING FORM <br />