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Environmental Health Department <br />8. Owner’s Statement: <br />2 of 2 <br />X “Class A”: In the event of a consumer <br />complaint or reported food-borne illness <br /> “Class B”: For regular annual facility inspections <br />and in the event of a consumer complaint or <br />food-borne illness <br />SAN JOAQUIN <br />-COUNTY— <br />Nilah Hazard <br />Print Name <br />7. Delivery Limitation: Initial if you agree to abide by the following:NH <br />I understand that I may accept orders and payments via the internet, mail or phone. Direct and Indirect sales <br />may be made in person, via mail delivery, or using any other third-party delivery service throughout the state <br />of California only. <br />Owner’s Signature <br />6/30/26 <br />Date <br />I,Nilah Hazard agree to grant access to the local health <br />department to conduct an inspection of my cottage food operation (mark one) <br />I,Nilah Hazard , agree to notify the San Joaquin County <br />Environmental Health Department 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.