COFA Certification Application

Application for Certification

Farm, Ranch or Facility Name:

Number of Farms:    Ranches:     Locations:     Lots:    Parcels:

Grower / Handler / Processor Name:

Address:

City:     State:     Zip:

Telephone:     Fax:     E-Mail:

California State Organic Registration Number:

Department of Health Services Number (if applicable):

New Application? Yes No     Annual Update? Yes No     How many years certified?

List previous Certification Agent for each of the last five (5) years:

How many acres do you farm?    How many acres are farmed organically?

How many acres are farmed non-organically?

Is your gross agricultural income from organic sales $5,000 or less? Yes No

IF YES, DO NOT PROCEED. You are exempt from certification. (NOP 205.101)

You may continue if you still wish to be certified by COFA.

How many years have you been in production, handling / processing at your location?

How are your commodities / products marketed? (Check all that apply) Wholesale Retail

Processor Contract buyer / handler Farmer’s Market Other: (please describe)

Please list all grower / brokers / handlers / processors / retailers with whom you will do business:

What brand name(s) / label(s) will be used to represent your product?

Please list organic and non-organic labels.

Prohibited Substance Prevention Practice

(NOP 205.272)

Describe your schedule for cleaning of equipment and documentation procedures:

Describe your plan to assure organic integrity:

(Packaging materials, storage containers, contamination prevention, etc.)

Describe your audit trail (tracking system):

(Bill of Lading, invoices, receiving, coding from input to finished product.)

Describe your methods of soil fertility management:

Describe your methods of pest management: (Insects, diseases, rodents, weeds, ets)

Handling Operations Exemptions and Exclusions.

(NOP 205.101)

Is your operation a retail food establishment or portion of a retail food establishment that handles but does not process organically produced agricultural products? Yes No

Does your handling operation handle agricultural products that contain less than 70 percent organic ingredients by total weight of finished product (excluding water and salt)? Yes No

Does your handling operation identify organic ingredients on your label? Yes No

If your organic ingredients are less than 70 percent, do you display the organic ingredients on your label? Yes No

Do you use products from an exempt production operation as ingredients identified as organic in your product? Yes No

Do you use organic products that are packaged or otherwise enclosed in a container? YesNo

Do the organic packaged products remain in the same package or container while in your control? Yes No

In your retail food establishment or portion of a retail food establishment do you handle raw and ready-to-eat food from agricultural products that were previously labeled as 100 percent organic, organic or made with organic? Yes No

IF YOU ANSWERED YES to any of the above questions, you may be exempt from certification. Please review Section 205.101 NOP. If you meet the requirements for exemption and exclusion of Section 205.101(a)(3) or (a)(4), you are still required to maintain records for no less than 3 years beyond their creation and you must allow representatives of the Secretary and the applicable governing State official access to your records for inspection and copying during normal business hours.

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