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2096934145 p.7Marsha Nandani Raj8-May-2025 13:41 <br />1'01 moie intorinaLoii see CDPH website <br />Owner’s Sfafteiture <br />! <br />CFC REG/PERMrrnNG FORM5EHD -16 27 8/29/2023 <br />Gharu Panday <br />Pont Name <br />03.10.2025 <br />Date <br /> <br /> Nitrite Test (every 3 years*)-' <br />’’Additional intormation may ba required if food is prepared from a home with 8 private v/aiei supply -checK wth iocat jurisdiction. <br />I | “Class B”: For regular annual facility <br />inspections and in the event of a consumer <br />complaint or food-borne <br />11. Owner’s Statement: <br />I, Chan.! Psndev . agree to grant access io lhe local health <br />department to conduct an inspection of my cottage food operation (made one) <br />9. Employee: Initial if you agree to abide by the foliowing: <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 />£2 “Clacc A:’: In the cvc-nt of s consumer <br />complaint or reported food-bo me illness <br />I, Charu Pan dev . agree to notify the San Joaquin County <br />Environmental Keatth Department prior to modifying my food list type of operation, andfor method <br />of selling, distributing., or otherwise providing my CFO products to the consumer or retaifors, <br />regardless of whether the product is sold, consigned, or given away. <br />I <br />... '__ . -7 <br />8. Food Processor Course: Initial if you agree to abide by the following: <br />Within 3 months of being approved to operate by the Environmental Health Department, please <br />provide proof of completion of the California Food Handler course in lieu of the California Department <br />of Public Health i'CDPH)food processor course. <br />10. 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. 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.