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Environmental Health Department <br />7. Delivery Limitation: <br />8. Owner’s Statement: <br />Michele Jacobs <br />Owner's Signature Print Name <br />2 of 2 <br />[x] “Class B”: For regular annual facility inspections <br />and in the event of a consumer complaint or <br />food-borne illness <br />Initial if you agree to abide by the following: MJ <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 />□ “Class A”: In the event of a consumer <br />complaint or reported food-borne illness <br />SAN JOAQUIN <br />-COUNTY— <br />03/17/2Q26 <br />Date <br />I, Michele Jcobs, agree to grant access to the local health department to <br />conduct an inspection of my cottage food operation (mark one) <br />I, Michele Jacobs , agree to notify the San Joaquin County Environmental <br />Health Department prior to modifying 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.