Farm Information

Farm Information

Farm Location:

Legal description/GPS/Lat-Long of location:

Total Acres farmed:

Crop Grown / Previous land use/crop / # of Acres

Food Safety Plan

1. All employees are required to attend training session on food safety, sanitation, and hygiene
2. All employees are required o complete a checklist explaining farm policies in effect during the period of employment
3. The food safety plan will be reviewed on an annual basis. All documentation will be retained for two (2) years

General and Contact Information

Farm Name:

Farm Owner:

Phone Number:

Food Safety Coordinator or designee:

Phone Number:

Farm Address:

Farm Phone Number:

Farm Fax Number:

E-Mail Address:

Emergency Contact number:

Disciplinary Policy for Food Safety Violations

If an employee is observed to be violating the established Food Safety Policies for ______, he/she will be:

Given a warning regarding the violation and reminded of proper food safety rules.

The employee will be instructed to review the Farm Policy Form.

The employee will be removed from their position on the farm for repeat offenses

Worker Health and Hygiene

Potable water is available to all employees

Visitors are required to follow sanitation practices outlined in the policy

All employees have been trained in proper sanitation and hygiene practices annually and are required to
follow proper sanitation and hygiene practices

Signs are posted instructing employees to wash their hands before beginning to returning to work.

Employees are required to wash their hands before beginning or returning to work.

All field sanitation units are equipped with single use towels, toilet paper, soap, and potable water for adequate hand washing.

Toilets are cleans and serviced on a scheduled basis

Smoking and eating are confined to designated locations outside crop production areas.

 Employees with diarrhea of symptoms of other infectious disease are prohibited from handling fresh produce

Employees are to notify their supervisor/designee if any commodity is exposed to blood or other body fluids. All contaminated products are to be destroyed,

Employees are to seek prompt treatment form their supervisor/designee with clean first aid supplies for cuts, abrasions, and other injuries.

All employees that apply regulated materials in the crop production areas are properly trained and/of licensed,

All unsecured jewelry or hand jewelry which cannot be sanitized is removed or covered if food ins manipulated by hand

WATER TESTING POLICY AND LOG SHEET

Water used for drinking, hand washing, and on harvested crops is potable. Potable water is available to all employees. Water used for chemical application and irrigation is known to be adequate for its intended use.

Water Source / Name/ Location / Testing date / Testing Lab / Results Attached
Spring
Fall
Spring
Fall
Spring
Fall
Spring
Fall
Spring
Fall

An alternative, emergency water source is available via:

Bottled water A private source with daily disinfection and chlorine testing

 A tested private source Other (explain:)

Field Visitor Policy and Log Sheet

Any non-farm employee, service employee, or person(s) who visits the farm, is instructed at the beginning of the season on proper health and hygiene practices and is required to sign the visitor log.

Date / Visitor Name / Company / Nature Of Visit

Toilet/Restroom/Field Sanitation Cleaning Log

Field sanitation unites are placed appropriately to minimize the risk of product contamination. Field sanitation units are placed in a location that is easily accessible for cleaning and service. A farm employee will be responsible for checking, on a daily basis, cleaning of the sanitation facility (port-o-potty), and replacing toilet paper, single use towel, and soap as necessary. These activities include community bathrooms used be farm employees.

Date / Sanitation checked/cleaned / Supplies checked/cleaned / Initials

Place a copy of this log at each facility.

Employee Infectious Disease Policy and Log

Employees with diarrhea, an open lesion, or other abnormal source of microbial contamination, including infectious diseases are prohibited from any tasks that may result in contamination until the condition is corrected. Employees are to notify their supervisor immediately if they are experiencing diarrhea or other infectious disease symptoms (see the Appendix for a list of pathogens and associated symptoms).

Date / Employee Name / Event Description / Action Taken / Supervisor

Product Contamination – Blood/Body Fluid Policy and Log

Employees are to notify their supervisor/designee if any commodity is exposed to blood or other bodily fluid (human or animal). The supervisor/designee is instructed to destroy/dispose of the contaminated product, clean/sanitize food contact surfaces, and complete the log sheet

Date / Event description / Action Taken / Supervisor

Traceability Policy

• Each production area is identified or coded to enable traceability in the event of a recall, (these codes should be included on your farm maps).
• All deliveries of produce to will be accompanied by a Delivery Form that includes the following information:

Farm/Grower Name:Delivery date:

Harvest Date:Crop/Variety:

Number of units:Farm Block # or Name:

Delivered by:

It is important to document any “MOCK” recalls that you may have. In a mock recall, you would contact your processor and advise that you were conducting a “mock” recall you will need to provide the processor with tanks/box/bin numbers that represent your produce for them to locate for the drill. Once the produce has been located as for a faxed confirmation or copies of tags associated the recalled product. You will need to develop a plan of action where you identify whether you will destroy/dispose of the product. Develop and record dates, times, and whom you have interacted with. All written correspondences should be included i.e. faxes, email.

First Aid Policy and Log

Employees are expected to seek prompt treatment from a supervisor/designee with clean first aid supplies for cuts, abrasions, and other injuries no matter how minor. All cuts and abrasions must be properly covered before the employee returns to handling food or working around food or working around food contact surfaces. First aid cabinets/kits need to be kept current and need to be inspected for expiration dates, and placed in an area convenient for supervisor/designee access.

Date / Description / Action Taken / Supervisor

Pre-harvest/Post-harvest Material

APPLICATOR POLICY

Personnel will have a working knowledge of, and comply with proper use of pre-harvest (pesticides, growth regulators, and fertilizers) and/or post-harvest application material (waxes, fumigants, and pesticides). Working knowledge will include the appropriate concentration and what to do if there is a spill.

When licensed or trained contractors are completing the use of materials, knowledge is demonstrated as Federal, State, or Local Laws cover applicators. Persons applying regulated or restricted use materials will meet all applicable state, Federal, and Local training and licensing requirements. If no restricted use materials are, being used the applicator will hold training documents that prove they have received training on proper use. Spray records will be made available to inspector upon request. Products applied by the Monte Vista Cooperative and areas where applications have taken place can be found by clicking on the link: Please go to the website, download and follow the prompts.

Insert your annual water reports here include one for each well or source utilized as potable water

You will need to insert any pesticide applicator licenses here

If there are additional employees applying pesticides, make a statement that says

“ has been trained by , in the proper handling of chemicals, amounts required per acre, correct disposal of product, and all other legal safety practices for application”.

Water Usage and Quality Risks

• Documentthe source of irrigation water; have all water sources used in crop production are tested for microbial contamination?
• Complete a log sheet of irrigated crops, include irrigation type and acreages.
• Identify what steps are taken to protect irrigation water from contamination. Look at each production area in term of the proximity to surrounding land uses that could present possible polluted runoff (ex. Livestock production) and take the necessary steps to minimize the risk of contamination of the water source
• Do your water tests confirm that contamination has not occurred on your farm? Document what you do on your farm.
• Is there a proper chemical mixing pad utilized to prevent chemical contamination of the water source?
• Are livestock excluded from the area surrounding the water source?
• Is water an appropriate distance from fuel and pesticide storage facilities?
• Are back-flow valves installed on Chemigation /fertilization systems?
• When loading pesticide/herbicide is an air gap maintained to prevent backflow and well contamination?

IRRIGATION WATER SOURCE LOG SHEET

WATER SOURCE LOCATION / TESTING DATE / TESTING LAB WITH ADDRESS / ARE RESULTS ATTACHED

IRRIGATED CROP INFORMATION LOG SHEET

CROPS IRRIGATED / NUMBER OF ACRES / TYPE OF IRRIGATION / WATER SOURCE

NOTE: INCLUDE YOUR IRRIGATION WATER REPORTS HERE AS WELL AS ANY TESTING THAT BEEN DONE.

ALL WATER SOURCES FOR FARM USE MUST BE TESTED! THIS INCLUDES WELL OR SURFACE WATER USED FOR IRRIGATION, PESTICIDE OR FERTILIZER APPLICATION, COOLING, FROST CONTROL OR ANY OTHER SOURCE THAT CONTACTS THE PRODUCE. IF A WELL SERVES MULTIPLE APPLICATIONS IT SHOULD BE SO NOTED IN YOUR RECORDS.

SEWAGE TREATMENT LOG SHEET

Farm sewage treatment system are functional and operating properly? Y N

If no, please identify the problems and actions taken to correct the problem:

Is there any evidence of run-off or leaking? Y N

Are there any municipal or commercial sewage treatment facilities or waste material landfills adjacent to the farm?

 Y N

TYPE OF SEWAGE TREATMENT SYSTEM / LOCATION

ANIMAL/WILDLIFE /LIVESTOCK POLICY

Most crop production areas are located away from livestock production facilities, but if a crop production is located near or adjacent to livestock production, areas (within 1 mile) then steps to minimize the risk of contamination need to be implemented. These should include the proper management of manure lagoons and manure storage areas to prevent leaking, overflow, and/or run-off from contaminating crop production areas. Manure stored near or adjacent to crop production areas is contained to prevent contamination of crops. Measures are taken to taken to restrict livestock access to water sources used in crop production.

Crop production areas should be monitored on a scheduled basis for the presence of wild or domestic animals entering into the area. Document these observations, as well as identifying the means of control that is being utilized.

DATE / ANIMAL ACTIVITY / PROBLEM/CONCERN / DETERRENT ACTION

MANURE AND MUNICIPAL BIOSOLIDS POLICY

For this section, please choose and answer questions only that apply to your operation. Do not include options that are not applicable. There are three options for you to choose from; A – Raw Manure, B – Composted Manure, or C – No Manure/Bio solids

Document when raw manure is applied.

When raw manure is applied, it is incorporated at least 2 weeks prior to planting or a minimum of 120 days prior to harvest

Raw manure is not used on commodities that are harvested with 120-day s of planting

If a combination of raw and treated manure is used the manure is properly treated, composted or exposed to reduce the expected
levels of pathogens

Untreated manure is properly stored to prevent leaching or runoff to adjacent crop production areas

Analysis reports of raw manure, or raw manure combined with treated manure, compost manure or any combination of the three

Manure is applied in the fall of at the end of the season to all planned vegetable production ground when soils are warm, non-saturated and cover cropped

If applying manure in the spring or start of season, spread the manure two weeks before planting.

Raw Manure and Treated/Compost Application Log

Date / Field / Rate / Type of Manure / Crop / Date Planted / Harvest Date

Composted Manure

Only composted manure and/or treated bio-solids are used as a soil amendment

Composted manure/treated bio-solids are properly treated, composted or exposed to environmental conditions thusly lowering pathogen levels (treatments shown below)

Passive treatment – relies of time in conjunction with environmental factors

Active treatment – greater level of intentional management and greater input of resources

Composted manure/treated bio-solids are properly stored are properly stored and are protected to minimize recontamination using (Check all that apply0

Barriers

Physical containment

Coverage to prevent rain leaching

Analysis reports available with explanation of the treatment.

Composted Manure/Treated Bio-Solids Application Log

Date / Field / Rate / Type of Manure / Crop / Date Planted / Harvest Date

If No Manure /Bio-Solids are used

No manure or municipal bio-solids were used on for crop year 20 .

Signature:Date:

Soils and Land Use

Include farm information page for previous crop history

Previous land use was compatible with the growing and harvesting of commodities with minimal risk of microbial or other contamination

If there was a risk of previous land use causing contamination, the site has been tested and there was no risk of microbial or other contaminants: (reference soil analysis)

Crop production areas subject to flooding or with a history of flooding have been tested for microbial hazards: (reference soil analysis)

Attach soil test here if necessary

Traceability

Insert farm map here

Identify each block/growing are and include a legend if it is not self-explanatory

Field Sanitation and Hygiene

 Do a preharvest assessment of the crop production area

The number, condition, and placement of field sanitation units comply with OSHA standards, including:

• One toilet and one hand washing facility is provided for each 20 or less employees.
• Toilet facilities are adequately ventilated and have self-closing doors that latch from the inside for privacy
• Facilities are located within ¼ mile of work site.

Potable drinking water, toilets, and hand washing facilities are maintained and cleaned regularly

 If field sanitation units are not used and are not required by state/federal regulations, a toilet facility is readily available for all employees or within a ¼-mile walk from the work site or a designated vehicle for transportation to a toilet facility or sanitation unit.

 Field sanitation units are placed so as to minimize the risk of product contamination

Field sanitation units are placed in a location that is easily accessible for cleaning and servicing.

A response plan is in [lace in the event of a major spill or leak (policy and log)

REMEMBER! Smoking and eating are confined to designated areas separate from areas where product is handled.(this does in include production areas)

Date / Site / Potential contaminant risk / Mitigating Practices

Also include an emergency contact in case of an event on the farm.

Toilet/Restroom/Field Sanitation Cleaning Log

Date / Sanitation checked/cleaned / Supplies checked/replaced / Signature

Place a copy of the log at each facility. Initial each box as the task is completed the sign and date the log.

IN THE EVENT OF A SPILL OR LEAK, IMMEDIATELY CONTACT Name: at number

Field Sanitation Spill/Leak Policy and Log

In the event of a major spill or leak of a field sanitation unit or toilet facility, the contracted service provider or other environmentally qualified contractor will be contacted by the food safety advisor, foreman or other designee immediately to begin clean up and remediation of procedures, including identification, removal and disposal of contaminated product and sanitation of the unit itself.

Date / Event Description / Action Taken / Signature

If you have a sanitation service agreement and clean-up is included in the agreement inset a copy here

Field Harvesting and Transportation

All harvesting containers that come in direct contact with product are cleaned or sanitized on a scheduled basis (as clean as practical)

Hand harvest equipment is cleaned and disinfected on a scheduled basis under the supervisor or designee.

Harvest containers are inspected by (print name) or designee to determine if they are damaged. Damaged harvest containers are properly repaired or disposed of.

Harvesting equipment, which is exposed to product, is in good repair. (Print name) or their designee is responsible for checking equipment every days.

Light bulbs and glass on harvesting equipment is protected from breakage so as not to contaminate produce.

There is a standard operating procedure for measures taken in the event of product contamination by chemicals, petroleum, pesticides, or other contaminants.

Harvest containers are inspected prior to use and foreign materials removed.

Harvest containers are to be used for their original purpose. Employees are instructed in this policy

Water used in and/or during the harvest process is tested to be free of microbial contamination and be potable. See previously included water analysis report, unless a separate well is used.

Efforts are made to limit excessive dirt and mud from products or containers during harvest.

Transportation equipment used in the harvest and transport of product is in clean and good repair.

Is harvested product that is being moved from field to storage areas or processing plants covered during transportation?

In ranch or field, pack operations are only new or sanitized containers used for packing the product?

Are packaging materials used in ranch or field pack operations stored properly and protected from contamination?

Is product that is being moved out of the field uniquely identified for traceability purposes?

Insert harvesting equipment and container sanitizing or cleaning protocol here – write up a description of your sanitizing protocol be sure you identify what products you use, how often and worker instruction. Try to be as specific as possible.