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SAN :J O A Q U IN Envimilmental Hn31111 Department <br /> — C0t.) NTV <br /> 9. Employee: Initial if you agree to abide by the following: C- <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: CT <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 /> 1• nt r�+ , agree to grant access to the local health department to <br /> conduct an i pec ion of my co age food operation (mark one) <br /> �f <br /> Mass A": In the event of a consumer ❑ "Class li For regular annual facility <br /> complaint or reported food-borne illness inspections and in the event of a consumer <br /> complaint or food-borne <br /> I, CYAA\ m,jC 5\o021>S L>^ agree to notify the San Joaquin County <br /> Environmerr tal Health Depairtment 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 /> rl 11 In In hT J LVO ) •3 <br /> Own r•s Signature Print Name I Date <br /> EHD 16-27 6129117 5 of 5 <br /> CFO REG/PERMITTING FORM <br />