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For mom Informfluon sea COPH wabsHn ,o�pcaa g program �gea dE O[t ge po .eypA 1• EMP1QyVg;Initial if you agree to abide by the following: I understand that I may not have more than one full-time equivalent cottage food employee,not including a family member or household member of The cottage food operator,working within the registered or permitted area of a private home where the cottage food operator resides and where cottage food products are prepared or packaged for direct,indirect,or direct and indirect sale to consumers. 1. Dglivery Limi do : Initial if you agree to abide by the following: I understand that I may accept orders and payments via the internet,mail or phone.Direct and Indirect sales may be fulfilled in person,via mail delivery,or using any other third-party delivery service throughout the state of California only 1. 4wnet's Statement- 1 agree to grant access to the local health department to conduct an inspection of my cottage food operation(mark one) "Class A„_In the event of a consumer complaint or "Class 9 �,:onsumer orlity inspections and in sported food-borne illnesshe event of t or food-home I' "e " agree to notify the San Joaquin County Environmental Health Department prior to modifying my food list,type of operation,and/or method of selling,distributing,or otherwise providing my CFO products to the consumer or relailers,regardless of whether the product is sold,consigned,or given away, tell Owner's Signature Print Name Date