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SAN10 A Q U I N Environmental Health Department <br /> l.l71_JiVTY-- <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.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 /> 8. Owner's Statement: /Y/r //J�/� <br /> I, UI aa �iA V' -, agree to grant access to the local health department to <br /> con uct an in pection of my coftaah food operation(mark one) <br /> "Class A": In the event of a consumer ❑ "Class B": For regular annual facility inspections <br /> complaint or reported food-borne illness and in the event of a consumer complaint or <br /> food-bome illness <br /> I, I 1�,agree to notify the San Joaquin County Environmental <br /> Health Deegirtment prior to modi Ing 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 /> consigned, or given away. <br /> C � I � � a �� <br /> (E <br /> GD at <br /> ne gnature P2pt Name O <br /> EHD 1629 OMM 2 CFO REGMERMMING RENEWAL FORM <br />