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"Additional information may bo roquired if food is pre parod from home vgth a private wator supply—check with local jurisdiction <br /> $. Food Processor Course: Initial if you agree to abide by the followinc <br /> Anu <br /> Within 3 months of being approved to operate by the Environmental Health Department, please <br /> provide proof of completion of the California Food Handier coupe in lieu of the California Department <br /> of Public Health (CDPH) food processor course. <br /> For more information see CDPH websile www.cdnh.ca-aovtnmgrams/PagpsffdbCottageFood.asglx <br /> 9. Employee: Initial if you agree to abide by the followinc <br /> Anu <br /> I understand that I may not have more than one full-time equivalent cottage food employee, not <br /> including a family member or household member of the cottage food operator,working within the <br /> registered or permitted area of a private home where the cottage food operator resides and where <br /> cottage food products are prepared or packaged for direct, indirect, or direct and indirect sale to <br /> consumers. <br /> 10.Delivery Limitation: Initial if you agree to abide by the following:`A>nu_ <br /> I understand that I may accept orders and payments via the internet, mail or phone. Direct and <br /> Indirect sales may be fulfilled in person, via mail delivery,or using any other third-party delivery <br /> service throughout the state of California only- <br /> 11. wner's tate ent: <br /> I,_Annapoorani Srinivasa agree to grant access to <br /> the local health department to conduct an inspection of my cottage food operation (marts 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-borne <br /> I,_Annapoorani Srinivasa , agree to notify the San <br /> Joaquin County Environmental Health Department prior to modifying my food list,type of <br /> operation, and/or method of selling,distributing, or otherwise providing my CFO products to the <br /> consumer or retailers, regardless of whether the product is sold, consigned, or given away. <br /> Annapoorani Srinivasa 05/02/2024 <br /> Owner's Signature <br /> Print Name Date <br /> 7 CFO REGIRERMI710 <br /> El,1D iL-:7&Q 2023 <br />