Flint Fresh On-Farm Food Safety Checklist
Contact Information
Name of Producer(s)
Name of Farm
Farm Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
Email
example@example.com
Is there a dedicated point person in charge of food safety?
Yes
No
If Yes, Please List Below
Production Practices
Yes
No
N/A
Are wells protected from contamination?
Is raw manure incorporated at least 2 weeks prior to planting and/or 120 days prior to harvest?
Is the manure application schedule documented and filed onsite?
Is land use history available to determine the risk of product contamination (ie. Runoff from upstream, flooding, chemical spills or excessive agricultural crop application)?
Is the field exposed to runoff from animal confinement or grazing areas?
Is land that is frequently flooded used to grow crops?
Are coliform tests conducted on soil in frequently flooded land?
Are farm livestock, domesticated and wild animals restricted from growing areas?
Are portable toilets used in a way that prevents field contamination from waste water?
If irrigation is used what is the source?
Well
Stream
Pond
Municipal
Other
What types of manures are used?
Raw manure
Composted
Aged
No Manure Used
Product Handling
Yes
No
N/A
Are storage and packaging facilities located away from growing areas?
Is there risk of contamination with manure?
Are harvesting baskets, totes or other containers kept covered and clean (with potable water) and sanitized before use?
Is harvesting equipment that comes in contact with the products washed and sanitized?
Are product and non-product containers available and clearly marked?
Is dirt, mud or other debris removed from product before packing?
Are food grade packaging materials clean and stored in areas protected from livestock, pets, wild animals, and other contaminants?
Transportation
Yes
No
N/A
Is product loaded and stored to minimize physical damage and risk of contamination?
Is transport vehicle well maintained and clean?
Are there designated areas in transport vehicles for food products and nonfood items?
Are products kept cool during transit?
Worker Health and Hygiene
Yes
No
N/A
Is there a worker safety training program in place?
Are workers and visitors following good hygiene and sanitation practices?
Are smoking and eating confined to designated areas separate from product handling?
Are workers instructed not to work if they exhibit signs of infections (ie. fever, diarrhea, vomiting, etc?)
Do workers practice good hygiene by:
Wearing clean clothes and shoes?
Keeping hair restrained or covered?
Washing hands as required?
Covering open wounds with clean bandages and gloves?
Additional Information
Date
-
Month
-
Day
Year
Date
I confirm that the information provided above is accurate to the best of my knowledge
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